AYODEJI OLUSILE ROSANWO MD NPI 1902862360

NPI Information

NPI: 1902862360
Provider Name: AYODEJI OLUSILE ROSANWO, MD
Classification: Family Medicine - 207QG0300X
Entity Type: Individual

Specialization: Geriatric Medicine

Address:
101 E WT HARRIS BLVD
BUILDING 1000 - SUITE 1110
CHARLOTTE, NC
ZIP 28262
Phone: (704) 863-9850
Get Directions

Ayodeji Olusile Rosanwo, MD is a geriatric medicine family medicine in Charlotte, NC. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. Ayodeji Olusile Rosanwo, MD NPI is 1902862360. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

101 E WT HARRIS BLVD
BUILDING 1000 - SUITE 1110
CHARLOTTE, NC
ZIP 28262-485
Phone: (704) 863-9850
Fax: (704) 863-9851

The enumeration date for this NPI number is 4/25/2006 and was last updated on 2/24/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		2014-01481	NORTH CAROLINA	No
2	207QG0300X	Family Medicine	Geriatric Medicine	2014-01481	NORTH CAROLINA	Yes
3	207QG0300X	Family Medicine	Geriatric Medicine	01043372A	INDIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	200314410	MEDICAID	INDIANA
2	1902862360	MEDICAID	NORTH CAROLINA
3	NCL484A	MEDICARE PIN	NORTH CAROLINA
4	150640E	MEDICARE PIN	INDIANA
5	G49954	MEDICARE UPIN	INDIANA
6	NC2346	MEDICAID	SOUTH CAROLINA
7	NCL484C904	MEDICARE PIN	NORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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