Individual
ROBERT M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1041 SHARON RD STE 205, KING WILLIAM, VA 23086-3344
(804) 769-3096
(804) 769-3170
Mailing address
1041 SHARON RD STE 205, KING WILLIAM, VA 23086-3344
(804) 769-3096
(804) 769-3170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101259659
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05698
GROUP PTAN
VA
Enumeration date
06/06/2013
Last updated
10/31/2016
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