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Individual

SCOTT A ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1100 62ND AVE N, STE A, MYRTLE BEACH, SC 29572-2957
(843) 839-0957
(843) 839-0758
Mailing address
300 SINGLETON RIDGE RD, ATTN PNS CREDENTIALING, CONWAY, SC 29526-9142

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101053663
VA
207Q00000X
Family Medicine Physician
Primary
83593
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5632986
VA
05
835939
SC
Enumeration date
07/28/2005
Last updated
03/09/2026
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