Provider Demographics
NPI:1639391931
Name:GEORGE, ROSALYN (MD)
Entity Type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 MILITARY CUTOFF RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-2375
Mailing Address - Country:US
Mailing Address - Phone:910-256-4350
Mailing Address - Fax:910-239-5032
Practice Address - Street 1:710 MILITARY CUTOFF RD
Practice Address - Street 2:SUITE 320
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-2375
Practice Address - Country:US
Practice Address - Phone:910-256-4350
Practice Address - Fax:910-239-5032
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT183990207N00000X
NC2008-00054207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology