1841201522 NPI number — DR. ANNA MARIA GORANSDOTTER ROSENLIND DC

Table of content: DR. ANNA MARIA GORANSDOTTER ROSENLIND DC (NPI 1841201522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841201522 NPI number — DR. ANNA MARIA GORANSDOTTER ROSENLIND DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENLIND
Provider First Name:
ANNA MARIA
Provider Middle Name:
GORANSDOTTER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BYSTEDT
Provider Other First Name:
ANNA MARIA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841201522
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8229 BALLYMORE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTERSVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-895-8373
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17115 KENTON DR
Provider Second Line Business Practice Location Address:
SUITE 206A
Provider Business Practice Location Address City Name:
CORNELIUS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28031
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-892-1010
Provider Business Practice Location Address Fax Number:
704-892-1074
Provider Enumeration Date:
08/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  3431 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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