Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 34.014944 | OH |
Y | 2080P0214X | Pediatric Pulmonologist | 34.014944 | OH |
NPI | 1356845317 |
---|---|
Provider Name | Steven Jacob Rose |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2018 |
Last Update Date | 07/06/2021 |