Healthcare Provider Details

I. General information

NPI: 1629482211
Provider Name (Legal Business Name): SARAH ROSE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15204 OMEGA DR STE 200
ROCKVILLE MD
20850-4814
US

IV. Provider business mailing address

15204 OMEGA DR STE 200
ROCKVILLE MD
20850-4814
US

V. Phone/Fax

Practice location:
  • Phone: 301-330-7002
  • Fax: 301-330-7006
Mailing address:
  • Phone: 301-330-7002
  • Fax: 301-330-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11017785A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0085883
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: