Provider Demographics
NPI:1326661745
Name:ROSS, BRITTANY MCLEISH (DO)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MCLEISH
Last Name:ROSS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4210
Mailing Address - Country:US
Mailing Address - Phone:864-455-7895
Mailing Address - Fax:864-455-7807
Practice Address - Street 1:25 MICHIGAN ST NE STE 4200
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2559
Practice Address - Country:US
Practice Address - Phone:616-267-9150
Practice Address - Fax:616-267-1408
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010274172080P0202X
SCLL83200208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics