Individual
DR. JEAN MARIE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
755 W BIG BEAVER RD, 411, TROY, MI 48084-4900
(248) 362-2562
Mailing address
755 W BIG BEAVER RD, 411, TROY, MI 48084-4900
(248) 362-2562
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
JR051904
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2606317622
PROVIDER CODE BLUE CROSS
MI
Enumeration date
02/01/2008
Last updated
02/01/2008
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