Provider Demographics
NPI:1427283076
Name:ROSENBERG, IRVING LOUIS (MD)
Entity type:Individual
Prefix:DR
First Name:IRVING
Middle Name:LOUIS
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1153 E MAIN ST
Mailing Address - Street 2:PO BOX 2563
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8990
Mailing Address - Fax:740-687-8230
Practice Address - Street 1:618 PLEASANTVILLE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-3312
Practice Address - Country:US
Practice Address - Phone:740-689-6408
Practice Address - Fax:740-689-6409
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2016-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.120152207RR0500X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0102998Medicaid
OH0102998Medicaid