| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CHRISTIAN M ROSE | 1194266395 | 2017-03-20 |
Christian M Rose is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1194266395. Registration indicates Christian M Rose is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine: Sports Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine Sports Medicine, Allopathic & Osteopathic Physicians) (Family Medicine, )
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Christian M Rose MD, CAQSM |
| Practice Office Address | 11 MELNEA CASS BLVD BOSTON, MA US |
| Practice Office Telephone | 6174142080 |
| Practice Office Fax | 6174142090 |
| Mailing Address | 960 MASSACHUSETTS AVENUE FL 2 BOSTON, MA 021182690 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 1 Boston Medical Ctr Pl | Boston, MA 021182908 | 6176388000 |
| 409 W Broadway | South Boston, MA 021272245 | 6172697500 |
| 110 West Squantum Street | North Quincy, MA 021712122 | 6173763000 |
| Code | Practice | License No State |
|---|---|---|
| 207Q00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | 282318
MA |
| 207QS0010X PRIMARY | Allopathic & Osteopathic Physicians Family Medicine Family Medicine: Sports Medicine Primary Care/Family Planning/APRN/PA Family Medicine Sports Medicine Allopathic & Osteopathic Physicians Family Medicine | 282318
MA |
| 110126963A | MEDICAID | MA | |
| 3133401 | MEDICAID | NH |