Individual
DR. MARK ROSE
Active
Individual
DR. MARK ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD14469
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
055542001
BCBS
—
05
—
068783
—
OR
01
—
57597
WA L&I
—
05
—
8202269
—
WA
01
—
930027259
RAILROAD MEDICARE
—
01
—
D86800
GROUP HEALTH
—
01
—
JM9461
PACC
—
05
—
XPY186301
—
CA
Enumeration date
07/05/2006
Last updated
12/19/2007
Update your record
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