Provider Demographics
NPI:1043710312
Name:HAEUSLER ROSSAVIK, CAROLIN
Entity type:Individual
Prefix:
First Name:CAROLIN
Middle Name:
Last Name:HAEUSLER ROSSAVIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SUMMIT CROSSING PL STE 108A
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-2189
Mailing Address - Country:US
Mailing Address - Phone:704-865-2229
Mailing Address - Fax:704-865-2811
Practice Address - Street 1:620 SUMMIT CROSSING PL STE 108A
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2189
Practice Address - Country:US
Practice Address - Phone:704-865-2229
Practice Address - Fax:704-865-2811
Is Sole Proprietor?:No
Enumeration Date:2018-02-13
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-02466207V00000X
KS0546774207V00000X
KS05-46774207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology