Provider Demographics
NPI:1447271952
Name:ROZOS, CONSTANTINOS ADAMANTIOS (MD)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINOS
Middle Name:ADAMANTIOS
Last Name:ROZOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1106
Mailing Address - Country:US
Mailing Address - Phone:804-204-1524
Mailing Address - Fax:
Practice Address - Street 1:4012 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23221-1106
Practice Address - Country:US
Practice Address - Phone:804-204-1524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055357207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology