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NPI Code Detail

MEDICARE: EDWIN ALEJANDRO BURGOS ROSSY MD

MEDICARE: EDWIN ALEJANDRO BURGOS ROSSY 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1538777958
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWIN ALEJANDRO BURGOS ROSSY MD
Provider Business Mailing Address
First Line : 1638 OWEN DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3424
Country : US
Telephone Number : 910-615-3500
Fax Number :
Provider Business Practice Location Address
First Line : 1638 OWEN DR
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28304-3424
Country : US
Telephone Number : 910-615-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2020
Last Update Date : 06/08/2026

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