MEDICARE: HOLISTIC MEDICAL CONSULTANTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	35016	NC

General Provider Information

NPI Number	:	1093835514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLISTIC MEDICAL CONSULTANTS

Provider Business Mailing Address
First Line	:	19607 W CATAWBA AVE
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-4002
Country	:	US
Telephone Number	:	704-892-3433
Fax Number	:	704-892-3691

Provider Business Practice Location Address
First Line	:	19607 W CATAWBA AVE
Second Line	:
City	:	CORNELIUS
State	:	NC
Zip	:	28031-4002
Country	:	US
Telephone Number	:	704-892-3433
Fax Number	:	704-892-3691

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIELLE MALBASA ROSE
Credential	:	MD
Telephone Number	:	704-892-3433

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	08/22/2020

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Directions to “HOLISTIC MEDICAL CONSULTANTS ” Practice Location

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