Provider Demographics
NPI:1194803627
Name:ROSAN, STUART W (DO)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:W
Last Name:ROSAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 EASTON RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2017
Mailing Address - Country:US
Mailing Address - Phone:215-491-3606
Mailing Address - Fax:
Practice Address - Street 1:620 EASTON RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2017
Practice Address - Country:US
Practice Address - Phone:215-491-3606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003536L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30693Medicare UPIN
PA080838SWIMedicare ID - Type Unspecified