MEDICARE: MR. JEFFREY M ROSCH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD015039E	PA
2	207K00000X	Allergy & Immunology Physician	MD439200	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922007939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JEFFREY M ROSCH M.D.

Provider Business Mailing Address
First Line	:	800 SOUTH LOGAN BOULEVARD, SUITE 3200
Second Line	:
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-3050
Country	:	US
Telephone Number	:	814-944-2097
Fax Number	:	814-941-2303

Provider Business Practice Location Address
First Line	:	800 SOUTH LOGAN BOULEVARD
Second Line	:	SUITE 3200
City	:	HOLLIDAYSBURG
State	:	PA
Zip	:	16648-3050
Country	:	US
Telephone Number	:	814-944-2097
Fax Number	:	814-941-2303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	07/07/2020

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Directions to “ MR. JEFFREY M ROSCH M.D.” Practice Location

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