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General NPI Number Information
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NPI Number | 1609879196
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Entity Type | Individual
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Provider Name | ELIZABETH ANN ROSEBERRY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 05/10/2009
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Provider Practice Location Address
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Address Line | 1446 EAGLE PASS DR
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City | MARION
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State | OH
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Zip | 43302-8138
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Country | US
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Telephone | 740-382-3511
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Fax | 740-382-0682
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Provider Business Mailing Address
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Address Line | 1446 EAGLE PASS DR
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City | MARION
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State | OH
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Zip | 43302-8138
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Country | US
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Telephone | 740-382-3511
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Fax | 740-382-0682
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | H0774
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 0101045048
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 17120
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 35079875
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | M9182
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License Number State | ID
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Taxonomy #6
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 43579
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License Number State | CO
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Taxonomy #7
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 10702
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License Number State | ND
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