Provider Demographics
NPI:1528037918
Name:SEGAN, ROSS DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:DAVID
Last Name:SEGAN
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 1:60 MIDDLETOWN AVE
Mailing Address - Street 2:COVIDIEN SURGICAL DEVICES - MEDICAL AFFAIRS
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3908
Mailing Address - Country:US
Mailing Address - Phone:203-492-7250
Mailing Address - Fax:
Practice Address - Street 1:60 MIDDLETOWN AVE
Practice Address - Street 2:COVIDIEN SURGICAL DEVICES - MEDICAL AFFAIRS
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-3908
Practice Address - Country:US
Practice Address - Phone:203-492-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD61698208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD000Medicare UPIN