Provider Demographics
NPI:1750429718
Name:ROSMAN, BRETT STUART (PA-C)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:STUART
Last Name:ROSMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1032 JENSEN GROVE CT
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-5479
Mailing Address - Country:US
Mailing Address - Phone:919-552-8920
Mailing Address - Fax:
Practice Address - Street 1:441 LAKESTONE COMMONS AVENUE
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526
Practice Address - Country:US
Practice Address - Phone:919-577-0481
Practice Address - Fax:919-577-0512
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00924363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP78297Medicare UPIN