Provider Demographics
NPI:1346222684
Name:MOHR, ROSE MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSE
Middle Name:MARIE
Last Name:MOHR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:29101 HEALTH CAMPUS DR
Mailing Address - Street 2:BLDG. 2, STE 230
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5270
Mailing Address - Country:US
Mailing Address - Phone:440-835-6105
Mailing Address - Fax:440-835-6109
Practice Address - Street 1:29101 HEALTH CAMPUS DR
Practice Address - Street 2:BLDG. 2, STE 230
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5270
Practice Address - Country:US
Practice Address - Phone:440-835-6105
Practice Address - Fax:440-835-6109
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35036570M207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0956201Medicaid
OH341869891OtherTAX ID
OHM00756972Medicare ID - Type Unspecified
OH0956201Medicaid