Healthcare Provider Details

I. General information

NPI: 1265435150
Provider Name (Legal Business Name): DAVID A ROSADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S MAIN ST SUITE 6
CELINA OH
45822-2413
US

IV. Provider business mailing address

950 S MAIN ST SUITE 6
CELINA OH
45822-2413
US

V. Phone/Fax

Practice location:
  • Phone: 419-586-1118
  • Fax: 419-586-4300
Mailing address:
  • Phone: 419-586-1118
  • Fax: 419-586-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3563403
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: