Healthcare Provider Details

I. General information

NPI: 1497746408
Provider Name (Legal Business Name): JOEL ROSENSTOCK MD MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 HOWELL MILL RD NW STE 125
ATLANTA GA
30327-2100
US

IV. Provider business mailing address

3193 HOWELL MILL RD NW STE 125
ATLANTA GA
30327-2100
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-1223
  • Fax: 404-352-1226
Mailing address:
  • Phone: 404-352-1223
  • Fax: 404-352-1226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number032036
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: