Provider Demographics
NPI:1427167451
Name:LARRY ROSENBERG, M.D.
Entity type:Organization
Organization Name:LARRY ROSENBERG, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:REINELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-891-5524
Mailing Address - Street 1:92 CONGRESS ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4344
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:92 CONGRESS ST
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4344
Practice Address - Country:US
Practice Address - Phone:828-254-0277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
73196OtherBLUE CROSS BLUE SHIELD
NC89-73196Medicaid
NC2165781Medicare PIN
NC89-73196Medicaid