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NPI Code Detail

MEDICARE: JONATHAN ROZENBERG

MEDICARE: JONATHAN ROZENBERG
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
1390200000XStudent in an Organized Health Care Education/Training Program390200000X
2207R00000XInternal Medicine Physician0102209998VA

General Provider Information

NPI Number : 1821792482
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN ROZENBERG
Provider Business Mailing Address
First Line : 213 S JEFFERSON ST STE 1006
Second Line :
City : ROANOKE
State : VA
Zip : 24011-1713
Country : US
Telephone Number : 540-224-5516
Fax Number :
Provider Business Practice Location Address
First Line : 3 RIVERSIDE CIR
Second Line :
City : ROANOKE
State : VA
Zip : 24016-4955
Country : US
Telephone Number : 540-224-5170
Fax Number : 540-983-8229
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2023
Last Update Date : 05/07/2026

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Directions to “ JONATHAN ROZENBERG ” Practice Location

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