Provider Demographics
NPI:1679740211
Name:MICHELS, ROSS MCGUIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:MCGUIRE
Last Name:MICHELS
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 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:131 LILA DOYLE DR
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672-9495
Practice Address - Country:US
Practice Address - Phone:864-888-3717
Practice Address - Fax:864-672-7852
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA072010207RH0003X
SC38831207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC388315Medicaid
GA1679740211Medicare UPIN
SCSC71337951Medicare PIN