Individual
DR. MARIA C. DELA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1965 S FREMONT AVE, SUITE 300, SPRINGFIELD, MO 65804-2201
(417) 820-3760
(417) 820-3770
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
117175
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140715001
—
AR
05
—
203806203
—
MO
01
—
98644
AR BLUE SHIELD #
MO
Enumeration date
02/13/2007
Last updated
05/03/2013
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