Gwan, Ofundem Rose

Gwan, Ofundem Rose is an sole proprietor health care provider with primary practice located at 1406 S Vienna St , Ruston LA 71270-6428. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Gwan, Ofundem Rose can be contacted via phone (318) 232-2456.

Contact Information

Primary practice address
1406 S Vienna St Ruston LA 71270-6428
Phone: (318) 232-2456
Fax: (318) 232-2457
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD.203609 Louisiana
Allopathic & Osteopathic Physicians / General Practice 208D00000X MD.203609 Louisiana

Profile Details

NPI number 1245440940
LBN Legal business name Gwan, Ofundem Rose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2007
Last updated Jan 23rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245440940 NPPES
Louisiana MEDICAID 1459330

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