Individual
MIRANDA ELIZABETH ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
545 METRO PL S STE 100, DUBLIN, OH 43017-5353
(415) 671-2165
Mailing address
545 METRO PL S STE 100, DUBLIN, OH 43017-5353
(415) 671-2165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30017
WV
207Q00000X
Family Medicine Physician
35129488
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H609640
MEDICARE
—
Enumeration date
04/22/2014
Last updated
03/11/2024
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