Provider Demographics
NPI:1831185719
Name:ROSS, DOUGLAS S (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15 PARKMAN ST
Mailing Address - Street 2:THYROID UNIT WAC 730 MASSACHUSETTS GENERAL HOSPITAL
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-3117
Mailing Address - Country:US
Mailing Address - Phone:617-726-3872
Mailing Address - Fax:617-726-5905
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:THYROID UNIT WAC 730 MASSACHUSETTS GENERAL HOSPITAL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-3872
Practice Address - Fax:617-726-5905
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2012-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA45888207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6276907-002OtherCIGNA
MA4051319OtherAETNA
MAD94076075MGHOtherHARVARD PILGRIM
MA110039650AMedicaid
MA712839OtherTUFTS
MA3300251OtherUNITED
MDJ02058OtherBLUE SHIELD
MAD94076075MGHOtherHARVARD PILGRIM
MA712839OtherTUFTS