MEDICARE: DIONISIA ROSAL 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	207R00000X	Internal Medicine Physician	35-039128	OH

General Provider Information

NPI Number	:	1760500128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIONISIA ROSAL MD

Provider Business Mailing Address
First Line	:	9992 PEBBLEKNOLL DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45252-2108
Country	:	US
Telephone Number	:	513-931-9600
Fax Number	:	513-931-1898

Provider Business Practice Location Address
First Line	:	1380 COMPTON RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45231-3560
Country	:	US
Telephone Number	:	513-931-9600
Fax Number	:	513-931-1898

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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