Provider Demographics
NPI:1972571552
Name:ROSENBAUM, LEWIS H (MD)
Entity type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:H
Last Name:ROSENBAUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4384 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4475
Mailing Address - Country:US
Mailing Address - Phone:248-932-0255
Mailing Address - Fax:248-932-5626
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6710
Practice Address - Country:US
Practice Address - Phone:248-551-7009
Practice Address - Fax:248-551-2204
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301039781207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47714Medicare UPIN
MIM70220Medicare ID - Type Unspecified