Individual
DR. MILLA SERGEERNA ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
815 E 15TH ST, DOUGLAS, AZ 85607-1631
(520) 364-5437
(520) 364-4261
Mailing address
1205 F AVE, DOUGLAS, AZ 85607-1920
(520) 364-1429
(520) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
31249
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
832031
AHCCCS
AZ
05
—
832031
—
AZ
Enumeration date
03/22/2006
Last updated
10/02/2013
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