Provider Demographics
NPI:1215951181
Name:ROSENBERG, JOEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 21ST ST NW STE 700
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3372
Mailing Address - Country:US
Mailing Address - Phone:202-416-2000
Mailing Address - Fax:202-416-2007
Practice Address - Street 1:1133 21ST ST NW STE 700
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-416-2000
Practice Address - Fax:202-416-2007
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD7681207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD340071900Medicaid
DC022741800Medicaid
DC060040292Medicare PIN
DCC87889Medicare PIN
DC141978C29Medicare PIN
MD340071900Medicaid
MD066MMedicare PIN
DC022741800Medicaid