Provider Demographics
NPI:1053319095
Name:ROSIEK, BETSY (MD)
Entity type:Individual
Prefix:DR
First Name:BETSY
Middle Name:
Last Name:ROSIEK
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-9145
Mailing Address - Country:US
Mailing Address - Phone:317-385-1430
Mailing Address - Fax:
Practice Address - Street 1:1307 WILLOW CT
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-9145
Practice Address - Country:US
Practice Address - Phone:317-385-1430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042354A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200000720Medicaid
IN200000720Medicaid
945920HHMedicare PIN