Healthcare Provider Details

I. General information

NPI: 1932254687
Provider Name (Legal Business Name): ROLLYN MICHELLE ORNSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 STIRRUP CREEK DRIVE
DURHAM NC
27703
US

IV. Provider business mailing address

PO BOX 13289
DURHAM NC
27709
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-7235
  • Fax: 717-531-0067
Mailing address:
  • Phone: 717-531-7235
  • Fax: 717-531-0067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License NumberMD434243
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number2019-02123
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: