Provider Demographics
NPI:1386648202
Name:BROSS, RONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:J
Last Name:BROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1501 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2309
Mailing Address - Country:US
Mailing Address - Phone:610-821-2828
Mailing Address - Fax:610-821-7915
Practice Address - Street 1:1501 N CEDAR CREST BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2309
Practice Address - Country:US
Practice Address - Phone:610-821-2828
Practice Address - Fax:610-821-7915
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2021-05-26
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Provider Licenses
StateLicense IDTaxonomies
PAMD054380-L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016010790006Medicaid
PAG35588Medicare UPIN
PA892910ES2Medicare PIN
PA0016010790006Medicaid