Provider Demographics
NPI:1902055312
Name:ROEDER, ROSIANE ALFINITO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSIANE
Middle Name:ALFINITO
Last Name:ROEDER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1072 X RAY DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-7498
Mailing Address - Country:US
Mailing Address - Phone:704-671-1094
Mailing Address - Fax:
Practice Address - Street 1:315 19TH ST SE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4230
Practice Address - Country:US
Practice Address - Phone:828-325-9849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00050208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery