Individual
QUENTIN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
133 FAIRFIELD ST, ST ALBANS, VT 05478-1726
(802) 524-7100
(802) 524-7021
Mailing address
PO BOX 1359, WILLISTON, VT 05495-1359
(802) 524-7100
(802) 524-7021
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0420011032
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1011976
—
VT
01
—
P00256952
RAILROAD MEDICARE
VT
Enumeration date
06/07/2006
Last updated
05/02/2011
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