Provider Demographics
NPI:1144856097
Name:ROSS, CAMERON MICHAEL
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:MICHAEL
Last Name:ROSS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 795
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-0795
Mailing Address - Country:US
Mailing Address - Phone:304-337-6067
Mailing Address - Fax:
Practice Address - Street 1:240 ALLEGHENY HWY # A
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-5749
Practice Address - Country:US
Practice Address - Phone:304-636-0133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-22
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV33012207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine