Provider Demographics
NPI:1235399817
Name:HINER, ROSE LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:LEE
Last Name:HINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10024 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1829
Mailing Address - Country:US
Mailing Address - Phone:314-919-2500
Mailing Address - Fax:314-919-2577
Practice Address - Street 1:10024 WATSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1829
Practice Address - Country:US
Practice Address - Phone:314-919-2500
Practice Address - Fax:314-919-2577
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008016452207R00000X
MO2011001463207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine