Basic Information
| Provider Information | |||||||||
| NPI: | 1649268889 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROST | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | B | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BENEDICT | ||||||||
| OtherFirstName: | DEBORAH | ||||||||
| OtherMiddleName: | J | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 14836 POPLAR HILL RD | ||||||||
| Address2: | |||||||||
| City: | DARNESTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208743622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019632595 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 15225 SHADY GROVE RD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208503254 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3013300661 | ||||||||
| FaxNumber: | 3019776940 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | X | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | DO051889 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.