Provider Demographics
NPI:1104359165
Name:WEISMAN, ROSS E (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:E
Last Name:WEISMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:171 MAIN ST STE 203B
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721-1187
Mailing Address - Country:US
Mailing Address - Phone:508-881-3029
Mailing Address - Fax:508-881-1752
Practice Address - Street 1:83 SPEEN ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4183
Practice Address - Country:US
Practice Address - Phone:508-907-6544
Practice Address - Fax:508-651-1494
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAPA6088363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical