Healthcare Provider Details

I. General information

NPI: 1104849843
Provider Name (Legal Business Name): MICHAEL A ROSEMORE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 ALLISON BONNETT MEMORIAL DR
HUEYTOWN AL
35023-2317
US

IV. Provider business mailing address

PO BOX 2391
BIRMINGHAM AL
35201-2391
US

V. Phone/Fax

Practice location:
  • Phone: 205-491-3299
  • Fax: 205-744-8761
Mailing address:
  • Phone: 205-491-3299
  • Fax: 205-744-8751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO159
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberD0-159
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: