Basic Information
| Provider Information | |||||||||
| NPI: | 1790935005 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSSELL | ||||||||
| FirstName: | GERMAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1975 W 24TH ST | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853646105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283419522 | ||||||||
| FaxNumber: | 9283418492 | ||||||||
| Practice Location | |||||||||
| Address1: | 1975 W 24TH ST | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853646105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283419522 | ||||||||
| FaxNumber: | 9283418492 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2008 | ||||||||
| LastUpdateDate: | 08/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 50042 | AZ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.