Individual
CHRISTIAN M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, CAQSM
Contact information
Practice address
25 CARLETON ST, CAMBRIDGE, MA 02142-1323
(617) 253-4481
Mailing address
960 MASSACHUSETTS AVENUE, FL 2, BOSTON, MA 02118-2690
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
282318
MA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
282318
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110126963A
—
MA
05
—
3133401
—
NH
Enumeration date
03/20/2017
Last updated
12/05/2024
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