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AYODEJI OLUSILE ROSANWO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 E WT HARRIS BLVD, BUILDING 1000 - SUITE 1110, CHARLOTTE, NC 28262-3485
(704) 863-9850
(704) 863-9851
Mailing address
PO BOX 601888, CHARLOTTE, NC 28260-1888
(704) 863-9850
(704) 863-9851

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2014-01481
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01043372A
IN
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
2014-01481
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1902862360
NC
05
200314410
IN
05
NC2346
SC
Enumeration date
04/25/2006
Last updated
02/24/2017
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