Provider Demographics
NPI:1598200404
Name:POLLACK, ROSS (MD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:
Last Name:POLLACK
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 1:2 HAYWARD ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2113
Mailing Address - Country:US
Mailing Address - Phone:508-431-3600
Mailing Address - Fax:508-342-1905
Practice Address - Street 1:2 HAYWARD ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2113
Practice Address - Country:US
Practice Address - Phone:508-431-3600
Practice Address - Fax:508-342-1905
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-31
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA280268207R00000X
390200000X
MA291197207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program