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General NPI Number Information
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NPI Number | 1366414229
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Entity Type | Individual
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Provider Name | ROSE C BERNARD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2000 W BALTIMORE ST
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City | BALTIMORE
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State | MD
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Zip | 21223-1558
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Country | US
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Telephone | 410-382-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 14217 CANTRELL RD
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City | SILVER SPRING
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State | MD
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Zip | 20905-4423
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Country | US
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Telephone |
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | R065394
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License Number State | MD
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