Provider Demographics
NPI:1114993078
Name:TAUBMAN, ROSS E (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:E
Last Name:TAUBMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6100 DAYLONG LN
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1626
Mailing Address - Country:US
Mailing Address - Phone:443-535-8770
Mailing Address - Fax:443-535-8775
Practice Address - Street 1:6100 DAYLONG LN
Practice Address - Street 2:SUITE 102
Practice Address - City:CLARKSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21029-1626
Practice Address - Country:US
Practice Address - Phone:443-535-8770
Practice Address - Fax:443-535-8775
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD00677213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T31259Medicare UPIN