Individual
ROSS EDWARD BRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3917 WEST RD, SUITE 150, LOS ALAMOS, NM 87544-2275
(505) 662-4351
(505) 662-2932
Mailing address
3917 WEST RD, SUITE 150, LOS ALAMOS, NM 87544-2275
(505) 662-4351
(505) 662-2932
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44252
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34010900
—
WI
Enumeration date
07/08/2006
Last updated
10/26/2010
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