Provider Demographics
NPI:1528032489
Name:MARCHETTA, ROSS F (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:F
Last Name:MARCHETTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:799 WYE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2268
Mailing Address - Country:US
Mailing Address - Phone:330-666-1166
Mailing Address - Fax:330-668-3919
Practice Address - Street 1:3636 YELLOW CREEK RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2269
Practice Address - Country:US
Practice Address - Phone:330-666-1166
Practice Address - Fax:330-668-3919
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-05-5792M207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0804660Medicaid
E59341Medicare UPIN
OHMA0671912Medicare ID - Type Unspecified