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Dr. David Matthew Ross
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NPI Number Detailed Information
Provider Information:
| Name: | Dr. David Matthew Ross |
| Gender: | M |
| Provider License Number If Given: | D6659 |
NPI Information:
| NPI: | 1063411585 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 7/18/2005 |
| Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
| Address: | 1925 COMMERCIAL ST SE Salem, OR 97302 |
| Phone Number: | 5033636892 |
| Fax Number: | 5033781487 |
Provider Business Practice Location Address:
| Address: | 1925 COMMERCIAL ST SE Salem, OR 97302 |
| Phone Number: | 5033636892 |
| Fax Number: | 5033781487 |
Provider Taxonomy:
| Primary: | 1223G0001X |
| Secondary (if any): | |
| State: | OR |
