Provider Demographics
NPI:1346234069
Name:ROSINIA, GISELLE M (MD)
Entity Type:Individual
Prefix:MRS
First Name:GISELLE
Middle Name:M
Last Name:ROSINIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2 WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5700
Mailing Address - Country:US
Mailing Address - Phone:912-353-7744
Mailing Address - Fax:912-355-9124
Practice Address - Street 1:1000 TOWNE CENTER BLVD STE 1000B
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-4129
Practice Address - Country:US
Practice Address - Phone:912-353-7744
Practice Address - Fax:912-348-3589
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA040216208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA040216OtherSTATE LICENSE
SCG40216OtherSC MEDICAID
GA000685891AMedicaid
GABR2718611OtherDEA #
GA58-1102392OtherTAX ID #
GA000685891AMedicaid