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General NPI Number Information
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NPI Number | 1326402306
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Entity Type | Individual
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Provider Name | CLAIRE EDEN ROSE MD
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Gender | Female
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Dates
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Enumeration Date | 04/06/2016
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 8 MEMORIAL MEDICAL CT STE 1
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City | GREENVILLE
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State | SC
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Zip | 29605-4400
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Country | US
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Telephone | 864-295-3492
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Fax | 864-295-4817
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Provider Business Mailing Address
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Address Line | 8 MEMORIAL MEDICAL CT STE 1
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City | GREENVILLE
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State | SC
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Zip | 29605-4400
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Country | US
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Telephone | 864-295-3492
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Fax | 864-295-4817
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 86553
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 72688-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 86553
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License Number State | SC
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