Provider Demographics
NPI:1033106950
Name:ROST, CHARLES R (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:R
Last Name:ROST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2112 HARRISBURG PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-2644
Mailing Address - Country:US
Mailing Address - Phone:717-544-3059
Mailing Address - Fax:717-544-3638
Practice Address - Street 1:2112 HARRISBURG PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2644
Practice Address - Country:US
Practice Address - Phone:717-544-3059
Practice Address - Fax:717-544-3638
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2008-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD030935E207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01598802OtherCAPITAL BLUE CROSS
PA124951OtherHIGHMARK BLUE SHIELD
PA33609OtherAMERIHEALTH MERCY HEALTH
PA0009501550004Medicaid
PA4347043OtherAETNA NON-HMO
PA578996OtherAETNA HMO
PAC30914OtherHEALTH ASSURANCE
PA1519063OtherGATEWAY HEALTH PLAN
PA01598802OtherCAPITAL BLUE CROSS
PA33609OtherAMERIHEALTH MERCY HEALTH