Healthcare Provider Details

I. General information

NPI: 1447831060
Provider Name (Legal Business Name): TILMAN ROSALES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 02/08/2026
Certification Date: 02/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG 10-CRC RM 7-3750 10 CENTER DRIVE
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

BLDG 10-CRC RM 7-3750 MSC 1404 10 CENTER DRIVE
BETHESDA MD
20892-1404
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-5295
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD600004223
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: