Provider Demographics
NPI:1407937972
Name:ROSEDALE HEALTH & WELLNESS
Entity Type:Organization
Organization Name:ROSEDALE HEALTH & WELLNESS
Other - Org Name:ROSEDALE INFECTIOUS DISEASES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-948-8582
Mailing Address - Street 1:103 COMMERCE CENTRE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-5869
Mailing Address - Country:US
Mailing Address - Phone:704-948-8582
Mailing Address - Fax:704-948-8572
Practice Address - Street 1:103 COMMMERCE CENTRE DRIVE
Practice Address - Street 2:SUITE 103
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078
Practice Address - Country:US
Practice Address - Phone:704-948-8582
Practice Address - Fax:704-948-8582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty