Provider Demographics
NPI:1114285525
Name:ROSS, WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1689 CROWN AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6314
Mailing Address - Country:US
Mailing Address - Phone:717-481-8510
Mailing Address - Fax:
Practice Address - Street 1:1689 CROWN AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6314
Practice Address - Country:US
Practice Address - Phone:717-481-8510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-043328-L207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology