Provider Demographics
NPI:1609848928
Name:ROSE, ANELIA P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANELIA
Middle Name:P
Last Name:ROSE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6020 FAYETTEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9754
Mailing Address - Country:US
Mailing Address - Phone:919-572-2000
Mailing Address - Fax:919-572-2010
Practice Address - Street 1:6020 FAYETTEVILLE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9754
Practice Address - Country:US
Practice Address - Phone:919-572-2000
Practice Address - Fax:919-572-2010
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC200000934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129WTMedicaid
NC89129WTMedicaid
NCNC3634AMedicare PIN