Roscoe, Justin Theodore
Roscoe, Justin Theodore is an sole proprietor health care provider with primary practice located at 180 Admiral Cochrane Dr Ste 410&420 , Annapolis MD 21401-7300. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Roscoe, Justin Theodore can be contacted via phone (443) 351-3376.Contact Information
Primary practice address
180 Admiral Cochrane Dr Ste 410&420
Annapolis MD 21401-7300
Phone: (443) 351-3376
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | D0036008 | Maryland |
Profile Details
| NPI number | 1487622353 |
|---|---|
| LBN Legal business name | Roscoe, Justin Theodore |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Apr 13th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487622353 | NPPES |
| Maryland | MEDICAID | 2105110 00 |
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