Individual
MR. MARTIN PHILLIP ROSE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2501 OAKINGTON ST, APG, MD 21005-5131
(410) 278-5356
Mailing address
4841 SEVEN TRAILS CIR, ABERDEEN, MD 21001-2628
(410) 278-5356
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1042882
GA
Other
Enumeration date
12/14/2005
Last updated
07/08/2007
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