Provider Demographics
NPI:1063443604
Name:ROSE, STEPHANIE ANDREA (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANDREA
Last Name:ROSE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2333 ALUMNI PARK PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4012
Mailing Address - Country:US
Mailing Address - Phone:859-257-7910
Mailing Address - Fax:859-257-7899
Practice Address - Street 1:INTERNAL MEDICINE GROUP
Practice Address - Street 2:830 S. LIMESTONE, SUITE 304
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0582
Practice Address - Country:US
Practice Address - Phone:859-323-0303
Practice Address - Fax:859-323-1200
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2009-09-21
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Provider Licenses
StateLicense IDTaxonomies
MA227654207R00000X
KY42269207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine