| Doctor Name: | DR. WARREN ROSS |
| NPI Number: | 1083035372 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 0101258777 |
| Business Practice Address: | 554 Keily St Bumed Centralized Credential & Privileging Directorate Jacksonville, FL - 32212 |
| Business Phone Number: | 7579537550 |
| Business Fax Number: | 7579537560 |
| Mailing Address: | 554 Keily St, Bumed Centralized Credential & Privileging Directorate JACKSONVILLE |
| State: | FL |
| Postal Code: | 32212 |
| Phone Number: | 7579537550 |
| Fax Number: | 7579537560 |
| NPI Enumeration Date: | 01/03/2014 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 0101258777 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |