Individual
WALTER M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
231 E CHESTNUT ST, LOUISVILLE, KY 40202-1821
(502) 629-6000
(502) 451-4553
Mailing address
PO BOX 713350, CHICAGO, IL 60677-1392
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
02240
KY
207LP3000X
Pediatric Anesthesiology Physician
Primary
02240
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64022403
—
KY
Enumeration date
08/30/2006
Last updated
07/12/2023
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