Individual
EMILY B ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2525 W UNIVERSITY AVE, SUITE 300, MUNCIE, IN 47303-3400
(765) 281-2000
(765) 281-2062
Mailing address
1200 W WHITE RIVER BLVD STE 300, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
229887
MA
207RC0000X
Cardiovascular Disease Physician
01069694A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01069694A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01009911
RR MEDICARE PTAN
IN
01
—
P01214721
RR MEDICARE PTAN
IN
Enumeration date
07/17/2006
Last updated
02/19/2021
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