Basic Information
| Provider Information | |||||||||
| NPI: | 1902055312 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROEDER | ||||||||
| FirstName: | ROSIANE | ||||||||
| MiddleName: | ALFINITO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1072 X RAY DR | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280547498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046711094 | ||||||||
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| Practice Location | |||||||||
| Address1: | 315 19TH ST SE | ||||||||
| Address2: | |||||||||
| City: | HICKORY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286024230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8283259849 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2008 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 2017-00050 | NC | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.