Individual
DR. RAYMUNDO FEDERICO ROSALES II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2512 Q ST, SUITE B, BEDFORD, IN 47421-4928
(812) 277-0075
(812) 277-0089
Mailing address
PO BOX 324, BEDFORD, IN 47421-0324
(812) 277-0075
(812) 277-0089
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01061216A
IN
207P00000X
Emergency Medicine Physician
01061216A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000594475
BLUE SHIELD
IN
05
—
200528920
—
IN
05
—
200528920A
—
IN
Enumeration date
07/13/2006
Last updated
04/30/2009
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