Individual
DR. GARY L. ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, FNP, ENP, APRN
Contact information
Practice address
1755 ASHLEY HALL RD APT E2, CHARLESTON, SC 29407-3815
(843) 693-8385
Mailing address
1755 ASHLEY HALL RD APT E2, CHARLESTON, SC 29407-3815
(843) 693-8385
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
ME007961
SC
207P00000X
Emergency Medicine Physician
00007961-A
VA
207Q00000X
Family Medicine Physician
ME007961
SC
207QA0401X
Addiction Medicine (Family Medicine) Physician
ME007961
SC
363LP2300X
Primary Care Nurse Practitioner
ME007961
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000007961
SAMSA
TN
Enumeration date
08/05/2020
Last updated
03/28/2023
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