Healthcare Provider Details

I. General information

NPI: 1275500852
Provider Name (Legal Business Name): DAVID N ROSVOLD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 05/24/2021
Certification Date: 05/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 UNION ST SUITE 101
ROBBINSVILLE NJ
08691-4183
US

IV. Provider business mailing address

104 PHEASANT RUN SUITE 128
NEWTOWN PA
18940-3439
US

V. Phone/Fax

Practice location:
  • Phone: 609-890-6677
  • Fax: 609-890-7292
Mailing address:
  • Phone: 215-860-3344
  • Fax: 215-860-8950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA54640
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD034418E
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number25MA05464000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: