Individual
DR. JAMES GARY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 FISHER RD, SUITE 3-1, BERLIN, VT 05602-9516
(802) 225-7025
(802) 225-7104
Mailing address
130 FISHER RD, SUITE 3-1, BERLIN, VT 05602-9516
(802) 225-7025
(802) 225-7104
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
042-0010379
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042-0010379
LICENCE
UT
05
—
1008758
—
VT
Enumeration date
07/25/2006
Last updated
07/08/2007
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