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Individual

BERTRAND A ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1910
(757) 668-7213
(757) 668-8225
Mailing address
PO BOX 79137, BALTIMORE, MD 21279-0137
(757) 668-7200
(757) 668-9691

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101043290
VA
2080P0202X
Pediatric Cardiology Physician
Primary
0101043290
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0001154501
DE
05
0017091520001
PA
05
006722326
VA
05
129951400
MD
05
890510M
NC
05
9840399000
WV
Enumeration date
06/07/2006
Last updated
01/20/2010
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