Individual
KATHERINE ANNE ROZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2651 E DISCOVERY PKWY, BLOOMINGTON, IN 47408-3412
(812) 353-3719
(812) 353-3713
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01093704A
IN
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01093704A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
01093704A
IN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
A178928
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
090540A09
MEDICARE PTAN
IN
01
—
1101380920
ANTHEM PTAN
IN
05
—
300092530
—
IN
01
—
A178928
STATE MEDICAL LICENSE
CA
Enumeration date
04/02/2014
Last updated
09/20/2024
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