Provider Demographics
NPI:1376696534
Name:ROSE, CATHERINE M (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:M
Last Name:ROSE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3017 WILMINGTON PIKE
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4001
Mailing Address - Country:US
Mailing Address - Phone:937-299-9700
Mailing Address - Fax:937-299-9778
Practice Address - Street 1:3017 WILMINGTON PIKE
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-4001
Practice Address - Country:US
Practice Address - Phone:937-299-9700
Practice Address - Fax:937-299-9778
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2024-04-05
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Provider Licenses
StateLicense IDTaxonomies
OH35049950R207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRO0656053Medicare PIN
OHD16197Medicare UPIN