Organization
NATHANIEL ROSS MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL ROSS MD (PHYSICIAN/OWNER)
(219) 769-1670
Entity
Organization
Contact information
Practice address
8701 BROADWAY, MERRILLVILLE, IN 46410-7035
(219) 769-1670
(219) 738-6714
Mailing address
55 E 86TH AVE, PO BOX 10645, MERRILLVILLE, IN 46410-6382
(219) 769-1670
(219) 738-6714
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01052287
IN
Other
Enumeration date
08/05/2006
Last updated
08/22/2020
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