Healthcare Provider Details

I. General information

NPI: 1629915442
Provider Name (Legal Business Name): OTTO ROZA M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 THOMAS JOHNSON DR STE 202
FREDERICK MD
21702-4485
US

IV. Provider business mailing address

12931 OAK HILL AVE
HAGERSTOWN MD
21742-2914
US

V. Phone/Fax

Practice location:
  • Phone: 301-694-7788
  • Fax:
Mailing address:
  • Phone: 301-797-9600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: JENN DAWN ROHRER
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-797-9600