Individual
RANDY ALLEN ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
42958
KY
207RN0300X
Nephrology Physician
MD035327E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1048161
—
PA
01
—
110029895
RR MEDICARE
—
05
—
1912005117
—
KY
Enumeration date
11/02/2005
Last updated
03/22/2010
Update your record
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