Provider Demographics
NPI:1699094128
Name:SMORGICK-ROSENBAUM, NOAM (MD)
Entity type:Individual
Prefix:DR
First Name:NOAM
Middle Name:
Last Name:SMORGICK-ROSENBAUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NOAM
Other - Middle Name:
Other - Last Name:SMORGICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1500 E MEDICAL CENTER DR
Mailing Address - Street 2:L4510 WOMEN'S HOSPITAL
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5000
Mailing Address - Country:US
Mailing Address - Phone:734-615-5120
Mailing Address - Fax:734-764-7261
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:L4510 WOMEN'S HOSPITAL
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-615-5120
Practice Address - Fax:734-764-7261
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095773208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice