Provider Demographics
NPI:1942273081
Name:SLADEK-LAWSON, ROSEMARIE (MD)
Entity Type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:
Last Name:SLADEK-LAWSON
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 1:802 GREEN VALLEY RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-7041
Mailing Address - Country:US
Mailing Address - Phone:336-802-2536
Mailing Address - Fax:336-802-2534
Practice Address - Street 1:1701 WESTCHESTER DR
Practice Address - Street 2:SUITE 850
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7008
Practice Address - Country:US
Practice Address - Phone:336-802-2536
Practice Address - Fax:336-802-2534
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6545208000000X
NC2009-01991208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5914605Medicaid
NV370022157OtherRAILROAD MEDICARE
NV002016793Medicaid
NVF18314Medicare UPIN
NV002016793Medicaid