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Individual

DR. RANDALL E ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
CO33497
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01334978
CO
01
1526353
UMWA
01
6640
BCBS
CO
01
841409708002
RMHMO
01
CO33497
RR MEDICARE
CO
01
P00175799
RR PIN
Enumeration date
12/04/2006
Last updated
05/19/2011
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