Individual
DR. DAVID CLARENCE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6192 DEVON DR, COLUMBIA, MD 21044-3821
(443) 528-2874
Mailing address
6192 DEVON DR, COLUMBIA, MD 21044-3821
(443) 528-2874
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA05852400
NJ
208000000X
Pediatrics Physician
D0046839
MD
208000000X
Pediatrics Physician
Primary
MD30077
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133469
—
NJ
05
—
034538700
—
DC
05
—
8751404
—
NJ
Enumeration date
10/17/2007
Last updated
09/02/2009
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