Healthcare Provider Details

I. General information

NPI: 1437421328
Provider Name (Legal Business Name): JEFFREY MARK ROSEMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 CLIFF RD S
BIRMINGHAM AL
35222-4330
US

IV. Provider business mailing address

4315 CLIFF RD S
BIRMINGHAM AL
35222-4330
US

V. Phone/Fax

Practice location:
  • Phone: 205-592-9563
  • Fax:
Mailing address:
  • Phone: 205-592-9563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number8771
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: