Individual provider · Type 1 NPI
Ofundem Rose Gwan, MD
General Practice Physician · Ruston, LA
NPI number
1245440940
Active
Practice location
1406 S Vienna St
Ruston, LA 71270-6428
Fax (318) 232-2457
Mailing address
282 John Wayne Dr
Lafayette, LA 70508-4918
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Internal Medicine Physician | 207R00000X | MD.203609 (LA) |
| General Practice Physician Primary | 208D00000X | MD.203609 (LA) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Another provider at this address
About NPI 1245440940
Ofundem Rose Gwan, MD's National Provider Identifier is 1245440940, issued on May 23, 2007. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Ruston, LA. The record was last updated on Jan 23, 2023.