Individual
DR. MICHAEL RAY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
600 N WOLFE ST, BALTIMORE, MD 21287-0005
(701) 261-8521
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
D97715
MD
208000000X
Pediatrics Physician
D97715
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123456789
N/A
—
Enumeration date
04/11/2019
Last updated
08/18/2023
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