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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

OFUNDEM ROSE GWAN, MD

Active Sole Proprietor

OFUNDEM ROSE GWAN, MD is a General Practice healthcare provider located in RUSTON, Louisiana. NPI 1245440940 is currently active in the NPPES registry. Verify at CMS.

General Practice · RUSTON, LA

Registration Details

NPI Number
1245440940
Provider Type
Individual
Gender
Female
NPI Issued
May 23, 2007 (19.242495964024 yrs)
Last Updated
Jan 23, 2023
Licenses
MD.203609 (LA)
MD.203609 (LA)
Sole Proprietor
Yes

Practice Information

Address
1406 S VIENNA ST
RUSTON, LA, 712706428
Browse LA providers · Browse ZIP 71270
Phone
3182322456
Fax
3182322457
Primary Specialty
General Practice
208D00000X
Additional Specialty
General Practice
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.