Individual
DR. DANIELLE MALBASA ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
129 WOODSON ST, SALISBURY, NC 28144-3255
(704) 636-5576
(704) 216-2011
Mailing address
129 WOODSON ST, SALISBURY, NC 28144-3255
(704) 636-5576
(704) 636-1755
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35016
NC
208000000X
Pediatrics Physician
35016
NC
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
35016
NC
2080P0006X
Developmental - Behavioral Pediatrics Physician
35016
NC
2086S0120X
Pediatric Surgery Physician
35016
NC
208D00000X
General Practice Physician
35016
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143J3
BCBS
NC
05
—
8910656
—
NC
Enumeration date
08/31/2006
Last updated
11/27/2018
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