Provider Demographics
NPI:1992916704
Name:GERMANI, ROSS MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:MICHAEL
Last Name:GERMANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DOCTORS DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4266
Mailing Address - Country:US
Mailing Address - Phone:864-572-7001
Mailing Address - Fax:
Practice Address - Street 1:1 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4266
Practice Address - Country:US
Practice Address - Phone:864-572-7001
Practice Address - Fax:864-412-0436
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC51320207Y00000X
OH35.093810207Y00000X
WV23779207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2965322OtherOH MEDICAID MOLINA
GE4272191OtherMEDICARE PTAN
OH000000274725OtherOH MEDICAID UNISON
SC513206Medicaid
WVGE4272192OtherMEDICARE
OH2965322Medicaid
KY7100151060Medicaid
WV1074772OtherBWC
OH310917085209OtherOH MEDICAID CARESOURCE
WVP00749569OtherMEDICARE RAILROAD
WV0049793000Medicaid
TINOtherOHIO HEALTH GROUP