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Individual

DR. DAVID S. ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1175 E MOUNTAIN BLVD, WILKES BARRE, PA 18702-7906
(570) 808-1093
(570) 808-7878
Mailing address
100 N ACADEMY AVE, CREDENTIALS DEPT, DANVILLE, PA 17822-4903
(570) 271-6144

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD053608L
PA
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
MD053608L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1017344800001
PA
Enumeration date
01/27/2006
Last updated
06/10/2020
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