Healthcare Provider Details
I. General information
NPI: 1215198080
Provider Name (Legal Business Name): EMMA CAROLINE ROSSI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/24/2008
Last Update Date: 09/20/2021
Certification Date: 09/20/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 N ELAM AVE
GREENSBORO NC
27403-1118
US
IV. Provider business mailing address
535 BARNHILL DR., RT 437
INDIANAPOLIS IN
46202
US
V. Phone/Fax
- Phone: 336-832-1100
- Fax:
- Phone: 317-944-7241
- Fax: 317-944-4878
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 01069785B |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VX0201X |
| Taxonomy | Gynecologic Oncology Physician |
| License Number | 200901878 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: