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Individual

DR. STEVEN BRYAN ROUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
154877-1
NY
207VG0400X
Gynecology Physician
Primary
MD039279L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009002150001
PA
05
00761519
NY
01
160049844
RR MEDICARE PIN
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039794
PA MEDICARE GROUP
PA
Enumeration date
02/13/2006
Last updated
09/16/2011
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