Provider Demographics
NPI:1730116757
Name:WESSELL, ROSALIE WINTER (PHD, MD)
Entity Type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:WINTER
Last Name:WESSELL
Suffix:
Gender:F
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:112 W MORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-4030
Mailing Address - Country:US
Mailing Address - Phone:215-743-6311
Mailing Address - Fax:215-242-4330
Practice Address - Street 1:4726 OXFORD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19124-5835
Practice Address - Country:US
Practice Address - Phone:215-743-6311
Practice Address - Fax:215-242-4330
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022844-E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0052988000Other10-DIGIT HMO ID PA
PAB40929Medicare UPIN
PA0052988000Other10-DIGIT HMO ID PA