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General NPI Number Information
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NPI Number | 1407922511
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Entity Type | Individual
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Provider Name | ALAN L. ROSENWASSER MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 12/21/2020
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Provider Practice Location Address
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Address Line | 401 DEVON PL SUITE 210
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City | KENT
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State | OH
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Zip | 44240-6482
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Country | US
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Telephone | 330-676-9465
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Fax | 330-677-5461
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Provider Business Mailing Address
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Address Line | 819 DOMINION DR
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City | KENT
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State | OH
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Zip | 44240-5015
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Country | US
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Telephone | 330-678-0588
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35-052639
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License Number State | OH
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