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General NPI Number Information
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NPI Number | 1225101488
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Entity Type | Organization
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Legal Business Name | MARIANNE W ROSEN, M.D.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 776 DANIEL ELLIS DR UNIT 1 A
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City | CHARLESTON
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State | SC
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Zip | 29412-3094
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Country | US
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Telephone | 843-723-6529
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Fax | 843-723-0424
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Provider Business Mailing Address
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Address Line | 776 DANIEL ELLIS DR UNIT 1 A
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City | CHARLESTON
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State | SC
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Zip | 29412-3094
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Country | US
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Telephone | 843-723-6529
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Fax | 843-723-0424
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Authorized Official
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Title or Position | PHYSICIANOWNER
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Name | DR. MARIANNE WAY ROSEN
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Credential | M.D.,
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Telephone | 843-723-6529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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