Individual
MS. RACHAEL L ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1619 W 5TH AVE, GARY, IN 46404-1506
(219) 886-4788
(219) 886-4106
Mailing address
PO BOX 4787, GARY, IN 46404-0787
(219) 886-4788
(219) 886-4106
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01057346A
IN
207Q00000X
Family Medicine Physician
Primary
01057346A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200504830A
—
IN
Enumeration date
09/13/2005
Last updated
02/23/2017
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