Provider Demographics
NPI:1144200866
Name:ROSS, JOHN JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JAMES
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15 FRANCIS ST
Mailing Address - Street 2:PBB-B420
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-278-0607
Mailing Address - Fax:617-264-5137
Practice Address - Street 1:15 FRANCIS ST
Practice Address - Street 2:PBB-B420
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-278-0607
Practice Address - Fax:617-264-5137
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA159533207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3199096Medicaid
MA3199096Medicaid
MAG98927Medicare UPIN