Provider Demographics
NPI:1629009014
Name:RICE, ROSELYN J (MD)
Entity type:Individual
Prefix:
First Name:ROSELYN
Middle Name:J
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1927 BELFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FREEMAN
Mailing Address - State:VA
Mailing Address - Zip Code:23856-2515
Mailing Address - Country:US
Mailing Address - Phone:631-476-4000
Mailing Address - Fax:631-476-4003
Practice Address - Street 1:150 KINGSLEY LN
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4602
Practice Address - Country:US
Practice Address - Phone:843-237-3378
Practice Address - Fax:843-237-5073
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040633207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP00337198OtherRAILROAD MEDICARE
VA010324050Medicaid
VA248473OtherBCBS OF VA
VA248473OtherBCBS OF VA
E58728Medicare UPIN