Individual
MR. BLAINE M ROSS
Active
Individual
MR. BLAINE M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
32191
AZ
207LP2900X
Pain Medicine (Anesthesiology) Physician
32191
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
986789
AHCCCS
AZ
01
—
AZ0156280
BCBS OF ARIZONA
AZ
01
—
P00376172
RAILROAD MEDICARE
AZ
Enumeration date
06/06/2006
Last updated
10/31/2007
Update your record
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