Ross, Nathaniel T

Ross, Nathaniel T is an sole proprietor health care provider with primary practice located at 1619 W 5Th Ave , Gary IN 46404-1506. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ross, Nathaniel T can be contacted via phone (219) 886-4788.

Contact Information

Primary practice address
1619 W 5Th Ave Gary IN 46404-1506
Fax: (219) 886-4106
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01052287 Indiana

Profile Details

NPI number 1417942707
LBN Legal business name Ross, Nathaniel T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2005
Last updated Dec 15th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417942707 NPPES
Georgia Other 080179270 MEDICARE RAILROAD
Georgia MEDICAID 200353510A MEDICARE RAILROAD

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