Provider Demographics
NPI:1902143233
Name:ROSENBAUM, BARRY JAY (M D)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:JAY
Last Name:ROSENBAUM
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CASTLEWAY DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3914
Mailing Address - Country:US
Mailing Address - Phone:404-325-4644
Mailing Address - Fax:
Practice Address - Street 1:2000 CASTLEWAY DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3914
Practice Address - Country:US
Practice Address - Phone:404-325-4644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015609207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology