Provider Demographics
NPI:1336498435
Name:ROSEMARY FADOOL DO PC
Entity Type:Organization
Organization Name:ROSEMARY FADOOL DO PC
Other - Org Name:ELEMENTS OF CARE OBGYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FADOOL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:623-544-1000
Mailing Address - Street 1:15515 N REEMS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374
Mailing Address - Country:US
Mailing Address - Phone:623-544-1000
Mailing Address - Fax:623-544-1025
Practice Address - Street 1:15515 N REEMS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374
Practice Address - Country:US
Practice Address - Phone:623-544-1000
Practice Address - Fax:623-544-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3674174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty