Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35484 | NC |
Y | 208600000X | Surgeon | 35484 | NC |
NPI | 1013917111 |
---|---|
Provider Name | Mr. Stephen Parker Rosser |
First Address | Statesville, NC 28677-3400 |
Second Address | Statesville, NC 28677-3400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 13/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8973422 | (05) | NC |
E29069 | (02) |