Provider Demographics
NPI:1841546033
Name:POWERS, ROSEMARY J-L (MD)
Entity type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:J-L
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSEMARY
Other - Middle Name:
Other - Last Name:JOHANN-LIANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15915 EMORY LN
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20853-1460
Mailing Address - Country:US
Mailing Address - Phone:240-753-3718
Mailing Address - Fax:
Practice Address - Street 1:15851 CRABBS BRANCH WAY
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2635
Practice Address - Country:US
Practice Address - Phone:240-753-3718
Practice Address - Fax:240-465-0396
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-25
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0062741208000000X, 2080P0208X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6206026-00Medicaid