Provider Demographics
NPI:1730264581
Name:ROSS, STEVEN E
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
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 1:3 COOPER PLZ RM 502
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:COOPER TRAUMA PHYSICIANS
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA435512086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ189214OtherAMERIHEALTH PPO/PA BS
NJ0091045000OtherAMERIHEALTH/KEYSTONE/IBC
NJ1241620OtherUNITEDH HEALTHCARE
NJ010003837OtherAMERICHOICE
NJP00289930OtherRR MEDICARE
PA001278500 0001Medicaid
NJ1107194OtherHORIZON NJ HEALTH
NJ2531101Medicaid
NJP931576OtherOXFORD
NJ3317303OtherAETNA
NJ3K6043OtherHEALTHNET
NJ60020063OtherHORIZON NJ HEALTH
NJ28235OtherUNIVERISTY HEALTH PLAN
NJ3161483OtherAETNA
NJ1241620OtherUNITEDH HEALTHCARE
PA001278500 0001Medicaid