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NPI Code Detail

MEDICARE: WHITNEY RONDELL ROSEN PA-C

MEDICARE: WHITNEY RONDELL ROSEN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant50.006111RXOH
2363A00000XPhysician Assistant50.006111RXOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093364911
Entity Type Code : Individual
Provider Name (Legal Business Name) : WHITNEY RONDELL ROSEN PA-C
Provider Business Mailing Address
First Line : 9049 SPRINGBORO PIKE
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-4926
Country : US
Telephone Number : 937-759-0545
Fax Number : 937-759-0549
Provider Business Practice Location Address
First Line : 9049 SPRINGBORO PIKE
Second Line :
City : MIAMISBURG
State : OH
Zip : 45342-4926
Country : US
Telephone Number : 937-759-0545
Fax Number : 937-759-0549
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2019
Last Update Date : 02/17/2025

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Directions to “ WHITNEY RONDELL ROSEN PA-C” Practice Location

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