Provider Demographics
NPI:1326018409
Name:YOUNGER, ROSS MARTIN (MD)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:MARTIN
Last Name:YOUNGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:895 MIDDLE GROUND BLVD
Practice Address - Street 2:SUITE 152
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4250
Practice Address - Country:US
Practice Address - Phone:757-599-5505
Practice Address - Fax:757-599-3618
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2013-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053011207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326018409Medicaid
VA1326018409Medicaid
VAH15391Medicare UPIN
VAP00331731Medicare PIN