Provider Demographics
NPI:1275502288
Name:WARHANK, ROSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:A
Last Name:WARHANK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSE
Other - Middle Name:A
Other - Last Name:MILLANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4210 FOREST RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-1540
Mailing Address - Country:US
Mailing Address - Phone:563-659-9137
Mailing Address - Fax:563-659-4438
Practice Address - Street 1:1008 11TH ST
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:IA
Practice Address - Zip Code:52742-1210
Practice Address - Country:US
Practice Address - Phone:563-659-9137
Practice Address - Fax:563-659-9869
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28338207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F41889Medicare UPIN