Provider Demographics
NPI:1588641500
Name:ROSS, JAMES GROOMS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:GROOMS
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2609 N DUKE ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704-3048
Mailing Address - Country:US
Mailing Address - Phone:919-220-2020
Mailing Address - Fax:919-220-9257
Practice Address - Street 1:2609 N DUKE ST
Practice Address - Street 2:SUITE 801
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-3048
Practice Address - Country:US
Practice Address - Phone:919-220-2020
Practice Address - Fax:919-220-9257
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35738207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC355030OtherMAMSI
NC92656OtherMEDCOST
NC76502OtherBCBS
NC1050314OtherUHC
NC1558732004OtherCIGNA
NCENT22OtherPRIMA
NC8976502Medicaid
NC2181219CMedicare ID - Type Unspecified
NC1558732004OtherCIGNA