Provider Demographics
NPI:1013181270
Name:ROSS, ROBERT MITCHELL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MITCHELL
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1701 WESTCHESTER DR
Mailing Address - Street 2:STE 850
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7254
Mailing Address - Country:US
Mailing Address - Phone:336-802-2400
Mailing Address - Fax:336-802-2001
Practice Address - Street 1:1401 OLD MILL CIR STE A
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2973
Practice Address - Country:US
Practice Address - Phone:336-768-0914
Practice Address - Fax:336-760-1896
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC24873207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890126YMedicaid
NC8973372Medicaid
NC202414GMedicare PIN
NC890126YMedicaid
NC2319157Medicare PIN