Provider Demographics
NPI:1811109416
Name:ROZARIO, CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:
Last Name:ROZARIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:R
Other - Last Name:GOMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:287 HIGHWAY 90 E
Mailing Address - Street 2:STE 6
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-7214
Mailing Address - Country:US
Mailing Address - Phone:843-357-1410
Mailing Address - Fax:843-357-1471
Practice Address - Street 1:287 HIGHWAY 90 E
Practice Address - Street 2:UNIT 6
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-7214
Practice Address - Country:US
Practice Address - Phone:843-741-0212
Practice Address - Fax:843-741-0213
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31751207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC31751OtherMEDICAL LICENSE NUMBER