=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104849843
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHAEL A ROSEMORE D.O.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2006
-----------------------------------------------------
Last Update Date | 09/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3004 ALLISON BONNETT MEMORIAL DR
-----------------------------------------------------
City | HUEYTOWN
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35023-2317
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-491-3299
-----------------------------------------------------
Fax | 205-744-8761
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2391
-----------------------------------------------------
City | BIRMINGHAM
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35201-2391
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-491-3299
-----------------------------------------------------
Fax | 205-744-8751
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | D0-159
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | DO159
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------