Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 0101238926 | VA |
N | 208D00000X | General Practice Physician | 0101238926 | VA |
NPI | 1043263890 |
---|---|
Provider Name | Robert A Rosen |
First Address | Culpeper, VA 22701-3942 |
Second Address | Culpeper, VA 22701-3942 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 05/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10287839 | (05) | VA |
246700 | BLUE SHIELD (01) | VA |
D19162 | (02) | VA |
P00348051 | RAILROAD MEDICARE (01) | VA |