Individual
STEVEN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 435-7334
Mailing address
7333 W JEFFERSON BLVD, FORT WAYNE, IN 46804-6280
(260) 435-7334
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027154A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100054210
—
IN
Enumeration date
06/15/2006
Last updated
11/02/2021
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