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General NPI Number Information
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NPI Number | 1508034471
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Entity Type | Individual
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Provider Name | RONALD ROSEDALE M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 12635 E MONTVIEW BLVD STE 131
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City | AURORA
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State | CO
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Zip | 80045-7335
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Country | US
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Telephone | 720-859-4132
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Fax |
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Provider Business Mailing Address
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Address Line | 12635 E MONTVIEW BLVD STE 131
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City | AURORA
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State | CO
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Zip | 80045-7335
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Country | US
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Telephone | 720-859-4132
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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 | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | 36003
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License Number State | CO
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