Individual
DR. ROSANA LABORDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
853 N CHURCH ST STE 401, SPARTANBURG, SC 29303-3064
(864) 560-6164
(864) 560-7092
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
31267
SC
208000000X
Pediatrics Physician
Primary
31267
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312673
—
SC
01
—
SCA1625019
MEDICARE PIN
SC
01
—
SCA162J577
MEDICARE PIN
SC
01
—
SCD5563365
MEDICARE PIN
SC
Enumeration date
10/12/2005
Last updated
04/20/2020
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