Individual
DR. GARY EDWARD ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
18101 OAKWOOD BLVD, ER DEPARTMENT, DEARBORN, MI 48124-4089
(313) 593-8780
(313) 436-2864
Mailing address
38935 ANN ARBOR RD, CREDENTIALING DEPT, LIVONIA, MI 48150-3397
(734) 805-0488
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101008141
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
GR008141
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11287313
CAQH
MI
Enumeration date
07/24/2006
Last updated
03/26/2014
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