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Individual

ANDREW L. ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11601 IRON BRIDGE RD, SUITE 117, CHESTER, VA 23831-1466
(804) 717-5300
(804) 748-7269
Mailing address
11601 IRON BRIDGE RD, SUITE 117, CHESTER, VA 23831-1466
(804) 717-5300
(804) 748-7269

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101056036
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005630231
VA
01
080121622
RAILROAD MEDICARE
VA
01
258474
MAMSI
VA
01
333344
ANTHEM BCBS OF VA
VA
01
43447
SENTARA
VA
01
5454581
AETNA HMO
VA
01
7533015
CIGNA
VA
01
78955
SOUTHERN HEALTH SERVICES
VA
01
C09633
GROUP PTAN
VA
Enumeration date
06/27/2006
Last updated
01/30/2012
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