Provider Demographics
NPI:1821858143
Name:ROSANDER, ABIGAIL (DO)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:ROSANDER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6233 W BEHREND DR APT 2060
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-6929
Mailing Address - Country:US
Mailing Address - Phone:435-757-5030
Mailing Address - Fax:
Practice Address - Street 1:717 SOUTH HOUSTON AVE, SUITE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127
Practice Address - Country:US
Practice Address - Phone:918-586-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program