Individual
DR. MARK J ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
367 W EVANS ST, FLORENCE, SC 29501-3429
(843) 669-4156
(843) 664-2121
Mailing address
367 W EVANS ST, FLORENCE, SC 29501-3429
(843) 669-4156
(843) 664-2121
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
11764
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180012103
RAILROAD MEDICARE
SC
01
—
276873
PRIVATE HEALTHCARE SYSTEM
SC
01
—
4254796
AETNA
SC
01
—
621812
SELECT HEALTH
SC
05
—
890602C
—
NC
01
—
9624212
GHI
SC
05
—
AT6689
—
SC
01
—
S327574
CIGNA
SC
Enumeration date
05/27/2005
Last updated
02/14/2024
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