Provider Demographics
NPI:1043233521
Name:ROSS, ROBERT MARK (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARK
Last Name:ROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12823 SAGAMORE RD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-1633
Mailing Address - Country:US
Mailing Address - Phone:816-861-4700
Mailing Address - Fax:
Practice Address - Street 1:12823 SAGAMORE RD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66209-1633
Practice Address - Country:US
Practice Address - Phone:913-449-1721
Practice Address - Fax:913-498-2358
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR5333207R00000X
KS04-17067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine