Provider Demographics
NPI:1508294323
Name:ROSEWOOD MEDICAL CONSULTING, PC
Entity Type:Organization
Organization Name:ROSEWOOD MEDICAL CONSULTING, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:610-678-6546
Mailing Address - Street 1:2211 QUARRY DR
Mailing Address - Street 2:E-61
Mailing Address - City:WEST LAWN
Mailing Address - State:PA
Mailing Address - Zip Code:19609-1161
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2211 QUARRY DR
Practice Address - Street 2:E-61
Practice Address - City:WEST LAWN
Practice Address - State:PA
Practice Address - Zip Code:19609-1161
Practice Address - Country:US
Practice Address - Phone:610-678-6546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053869L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty