=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467551861
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID CHRISTOPHER ROSKA D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2006
-----------------------------------------------------
Last Update Date | 12/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 231 WB MCLEAN DR
-----------------------------------------------------
City | CAPE CARTERET
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28584-8515
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-764-5414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 HOPE TOWN CT
-----------------------------------------------------
City | CEDAR POINT
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28584-4501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-764-5414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | 2009-01635
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------