MEDICARE: ROBERT H ROSSERO MD

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	207RI0200X	Infectious Disease Physician	4301081149	MI
2	207RI0200X	Infectious Disease Physician	6817	AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295729713
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT H ROSSERO MD

Provider Business Mailing Address
First Line	:	3340 PROVIDENCE DR
Second Line	:	SUITE 466
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4627
Country	:	US
Telephone Number	:	907-263-2200
Fax Number	:	907-276-0366

Provider Business Practice Location Address
First Line	:	3340 PROVIDENCE DR
Second Line	:	SUITE 466
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4627
Country	:	US
Telephone Number	:	907-263-2200
Fax Number	:	907-276-0366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	12/04/2015

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