Provider Demographics
NPI:1730449380
Name:ROSS, MEREDITH F (MD)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:F
Last Name:ROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:MEREDITH
Other - Middle Name:FERN
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 N ORANGE ST STE 304
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2951
Mailing Address - Country:US
Mailing Address - Phone:406-329-5781
Mailing Address - Fax:406-327-3331
Practice Address - Street 1:900 N ORANGE ST STE 304
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802
Practice Address - Country:US
Practice Address - Phone:406-329-5781
Practice Address - Fax:406-327-3331
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67565-020207RE0101X
MT-68189207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism