Provider Demographics
NPI:1508034471
Name:ROSEDALE, RONALD (MD)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:
Last Name:ROSEDALE
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 1:12635 E MONTVIEW BLVD
Mailing Address - Street 2:STE 131
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7335
Mailing Address - Country:US
Mailing Address - Phone:720-859-4132
Mailing Address - Fax:
Practice Address - Street 1:12635 E MONTVIEW BLVD
Practice Address - Street 2:STE 131
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7335
Practice Address - Country:US
Practice Address - Phone:720-859-4132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36003207QB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QB0002XAllopathic & Osteopathic PhysiciansFamily MedicineObesity Medicine