Individual
DR. CHARLES WILLIAM ROSCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2206 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 517-8627
(434) 517-8080
Mailing address
2206 WILBORN AVE, SOUTH BOSTON, VA 24592-1630
(434) 517-8627
(434) 517-8080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101043289
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006207332
—
VA
01
—
260341
ANTHEM
VA
01
—
43593
OPTIMA
VA
Enumeration date
07/17/2006
Last updated
10/12/2020
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