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NPI Code Detail

MEDICARE: MR. DENNIS ALLEN ROCHESTER P.A.-C

MEDICARE: MR. DENNIS ALLEN ROCHESTER P.A.-C
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
1363A00000XPhysician AssistantC00166MD

General Provider Information

NPI Number : 1679577464
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS ALLEN ROCHESTER P.A.-C
Provider Business Mailing Address
First Line : 9815 MAIN ST
Second Line : SUITE 208
City : DAMASCUS
State : MD
Zip : 20872-2002
Country : US
Telephone Number : 301-253-4004
Fax Number : 301-253-3391
Provider Business Practice Location Address
First Line : 9815 MAIN ST
Second Line : SUITE 208
City : DAMASCUS
State : MD
Zip : 20872-2002
Country : US
Telephone Number : 301-253-4004
Fax Number : 301-253-3391
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 08/20/2008

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