Provider Demographics
NPI:1366560260
Name:ROSE, PAULA GAYE (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:GAYE
Last Name:ROSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:262 TILGHMAN RD
Mailing Address - Street 2:PRMC OCCUPATIONAL HEALTH
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1921
Mailing Address - Country:US
Mailing Address - Phone:410-543-7188
Mailing Address - Fax:410-543-7505
Practice Address - Street 1:262 TILGHMAN RD
Practice Address - Street 2:PRMC OCCUPATIONAL HEALTH
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1921
Practice Address - Country:US
Practice Address - Phone:410-543-7188
Practice Address - Fax:410-543-7505
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0046915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0046915OtherPHYSICIAN AND SURGEON LIC
MDD0046915OtherPHYSICIAN AND SURGEON LIC