Provider Demographics
NPI:1841373214
Name:JUSTIN G. ROSEMORE, D.O., P.A.
Entity type:Organization
Organization Name:JUSTIN G. ROSEMORE, D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:GARTH
Authorized Official - Last Name:ROSEMORE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-455-9995
Mailing Address - Street 1:6209 GREEN MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3300
Mailing Address - Country:US
Mailing Address - Phone:410-585-0027
Mailing Address - Fax:410-585-1619
Practice Address - Street 1:2 W ROLLING CROSSROADS
Practice Address - Street 2:SUITE 206
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6208
Practice Address - Country:US
Practice Address - Phone:410-455-9995
Practice Address - Fax:410-455-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0055317207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty