Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | C10003569 | DE |
NPI | 1164514980 |
---|---|
Provider Name | Dr. Carlos D. Rose |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 16/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001426649 | (05) | PA |
01458153 | (05) | NY |
2015218 | (05) | MD |
6078508 | (05) | NJ |
6723179 | (05) | VA |
F48576 | (02) | |
Q03569 | (05) | SC |