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NPI Code Detail

MEDICARE: DR. ALEXANDER ROSE MD, MPHS

MEDICARE: DR. ALEXANDER ROSE MD, MPHS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician2016034315MO
22084F0202XForensic Psychiatry Physician2016034315MO

General Provider Information

NPI Number : 1326422841
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDER ROSE MD, MPHS
Provider Business Mailing Address
First Line : 8816 MANCHESTER RD # 282
Second Line :
City : BRENTWOOD
State : MO
Zip : 63144-2602
Country : US
Telephone Number : 314-380-8764
Fax Number : 314-293-6893
Provider Business Practice Location Address
First Line : 1034 S BRENTWOOD BLVD STE 555
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-1265
Country : US
Telephone Number : 314-380-8764
Fax Number : 314-293-6893
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2015
Last Update Date : 08/25/2025

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