Individual
ELIZABETH M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
165 DARTMOUTH ST, INTERNAL MEDICINE, BOSTON, MA 02116-5123
(617) 859-5108
(617) 859-5050
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
80364
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002366
NEIGHBORHOOD HEALTH
MA
01
—
080264
TUFTS
MA
05
—
3130169
—
MA
01
—
AA51853
HARVARD PILGRIM
MA
01
—
J31183
BLUE CROSS
MA
Enumeration date
06/26/2006
Last updated
10/06/2020
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