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Individual

DR. JOHN L ROUSSALIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.PC

Contact information

Practice address
537 STANTON CHRISTIANA RD, NEWARK, DE 19713-2146
(302) 633-7550
(302) 633-7556
Mailing address
537 STANTON CHRISTIANA RD, NEWARK, DE 19713-2146
(302) 633-7550
(302) 633-7556

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
MD426938
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
127068100
WY
01
W21591
PTAN
WY
Enumeration date
04/09/2007
Last updated
06/23/2021
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