Provider Demographics
NPI:1447228176
Name:LA ROSA, ANGELA ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:ROSE
Last Name:LA ROSA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10807 FALLS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4591
Mailing Address - Country:US
Mailing Address - Phone:410-321-9393
Mailing Address - Fax:410-825-4945
Practice Address - Street 1:10807 FALLS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4591
Practice Address - Country:US
Practice Address - Phone:410-321-9393
Practice Address - Fax:410-825-4945
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2010-10-01
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Provider Licenses
StateLicense IDTaxonomies
MDD0054924208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG76817Medicare UPIN