Individual
RUTH ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HOPI HEALTH CARE CENTER HIGWAY 264, MM 388, POLACCA, AZ 86042-4000
(928) 737-6000
(928) 737-6001
Mailing address
PO BOX 4000, POLACCA, AZ 86042-4000
(928) 737-6000
(928) 737-6001
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C63110
CA
207Q00000X
Family Medicine Physician
Primary
MD2006-0507
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
696809
—
AZ
Enumeration date
05/08/2007
Last updated
05/09/2024
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