Provider Demographics
NPI:1447207055
Name:JUERGENS, ROSALYN ANNE (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:ROSALYN
Middle Name:ANNE
Last Name:JUERGENS
Suffix:
Gender:F
Credentials:MD PHD
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Mailing Address - Street 1:JURAVINSKI CANCER CENTRE
Mailing Address - Street 2:699 CONCESSION STREET - FOURTH FLOOR ROOM 228
Mailing Address - City:HAMILTON
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:L0R 1K0
Mailing Address - Country:CA
Mailing Address - Phone:905-387-9711
Mailing Address - Fax:905-575-6326
Practice Address - Street 1:JURAVINSKI CANCER CENTRE
Practice Address - Street 2:699 CONCESSION STREET - FOURTH FLOOR ROOM 228
Practice Address - City:HAMILTON
Practice Address - State:ONTARIO
Practice Address - Zip Code:L0R 1K0
Practice Address - Country:CA
Practice Address - Phone:905-387-9711
Practice Address - Fax:905-575-6326
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2012-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD60203207R00000X, 207RX0202X
ZZ94794207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD014260300Medicaid
MD177948Y82Medicare PIN