Individual
RICHARD SUN KYU KWAN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 FOOTHILL DR, SLC, UT 84148-0001
(801) 582-1565
(801) 584-2576
Mailing address
500 FOOTHILL DR, SLC, UT 84148-0001
(801) 582-1565
(801) 584-2576
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5756670-1205
UT
207R00000X
Internal Medicine Physician
MD60136118
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0211RO
REGENCE
WA
01
—
0260516
L&I AND CRIME VICTIMS
WA
05
—
1447272323
—
WA
05
—
8567380
—
WA
01
—
9370535
AETNA
WA
Enumeration date
07/23/2006
Last updated
01/11/2012
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