Provider Demographics
NPI:1881647303
Name:ROSE HILL FAMILY PHYSICIANS, LLC
Entity type:Organization
Organization Name:ROSE HILL FAMILY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-228-1325
Mailing Address - Street 1:321 DORCHESTER AVE
Mailing Address - Street 2:SUITE1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-2419
Mailing Address - Country:US
Mailing Address - Phone:410-228-1325
Mailing Address - Fax:
Practice Address - Street 1:321 DORCHESTER AVE
Practice Address - Street 2:SUITE1
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-2419
Practice Address - Country:US
Practice Address - Phone:410-228-1325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0051793207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS326OtherCAREFIRST BLUE CHOICE
MDLY82OtherCARE FIRST BCBS
MD765900800Medicaid
MDLY82OtherCARE FIRST BCBS