Provider Demographics
NPI:1942326137
Name:O'GRADY, ROSEMARY CECILE (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:CECILE
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:MRS
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1942 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5128
Mailing Address - Country:US
Mailing Address - Phone:540-373-5164
Mailing Address - Fax:540-373-2281
Practice Address - Street 1:1942 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5128
Practice Address - Country:US
Practice Address - Phone:540-373-5164
Practice Address - Fax:540-373-2281
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103000653213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery