MEDICARE: MS. JULIE A ROTHMAN D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	OS005510L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1629079314	OTHER		NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629079314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE A ROTHMAN D.O.

Provider Business Mailing Address
First Line	:	205 GRANDVIEW AVE
Second Line	:	SUITE 402
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-972-2800
Fax Number	:	717-972-2845

Provider Business Practice Location Address
First Line	:	205 GRANDVIEW AVE
Second Line	:	SUITE 402
City	:	CAMP HILL
State	:	PA
Zip	:	17011-1708
Country	:	US
Telephone Number	:	717-972-2800
Fax Number	:	717-972-2845

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	06/03/2014

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