Healthcare Provider Details

I. General information

NPI: 1215951181
Provider Name (Legal Business Name): JOEL ROSENBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 21ST ST NW STE 700
WASHINGTON DC
20036
US

IV. Provider business mailing address

1133 21ST ST NW STE 700
WASHINGTON DC
20036-3372
US

V. Phone/Fax

Practice location:
  • Phone: 202-416-2000
  • Fax: 202-416-2007
Mailing address:
  • Phone: 202-416-2000
  • Fax: 202-416-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD7681
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: