Provider Demographics
NPI:1225199631
Name:ROSCHE MATZZIE, CLAIRE L (PA-C)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:L
Last Name:ROSCHE MATZZIE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:L
Other - Last Name:ROSCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15825 SHADY GROVE RD STE 140
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4015
Mailing Address - Country:US
Mailing Address - Phone:301-869-9776
Mailing Address - Fax:202-544-2714
Practice Address - Street 1:15825 SHADY GROVE RD STE 140
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4015
Practice Address - Country:US
Practice Address - Phone:301-869-9776
Practice Address - Fax:202-544-2714
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0005362363AM0700X
DCPA030358363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical