Individual
GARY LEE ROSELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3223 EDEN & ALBERT SABIN, CINCINNATI, OH 45267-0405
(513) 584-6868
(513) 584-6040
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5504
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35-036345
OH
207RI0200X
Infectious Disease Physician
Primary
35-036345
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0377131
—
OH
05
—
200147030
—
IN
05
—
64761349
—
KY
Enumeration date
05/03/2006
Last updated
08/10/2017
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