# MR. CARL H ROSEN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1316931959
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 30020 | KY | Yes |

## Other

- **Enumeration date:** 09/09/2005
- **Last updated:** 09/21/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000476600 | ANTHEM BLUE CROSS AND BLUE SHIELD | KY |
| 01 | — | 000000612653 | ANTHEMBCBS | KY |
| 01 | — | 10810680 | CAQH | KY |
| 01 | — | 50023040 | PASSPORT HEALTH | KY |
| 05 | — | 64300205 | — | KY |