# GWEN ROESEL MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649420258
- **Authorized official:** DR. GWEN C ROESEL MD (PRESIDENT)
- **Authorized official phone:** (513) 271-2862

## Contact information

- **Practice address:** 9435 WATERSTONE BLVD, SUITE 140, CINCINNATI, OH 45249-8226
- **Practice address phone:** (513) 271-2862
- **Practice address fax:** (513) 271-0619
- **Mailing address:** 9435 WATERSTONE BLVD, SUITE 140, CINCINNATI, OH 45249-8226
- **Mailing address phone:** (513) 271-2862
- **Mailing address fax:** (513) 271-0619

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 35.090806 | OH | Yes |

## Other

- **Enumeration date:** 09/19/2008
- **Last updated:** 01/10/2014