Healthcare Provider Details

I. General information

NPI: 1871349613
Provider Name (Legal Business Name): ROSA KARIMI PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21044 FREDERICK RD
GERMANTOWN MD
20876-4132
US

IV. Provider business mailing address

9232 ORCHARD BROOK DR
POTOMAC MD
20854-2405
US

V. Phone/Fax

Practice location:
  • Phone: 240-238-5432
  • Fax:
Mailing address:
  • Phone: 703-231-4470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009563
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: