Healthcare Provider Details

I. General information

NPI: 1568596195
Provider Name (Legal Business Name): DAVID H. ROSENBAUM II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 01/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HOSPITAL BLVD
JEFFERSONVILLE IN
47130-3769
US

IV. Provider business mailing address

1819 KNOLLWOOD RD
LOUISVILLE KY
40207-1766
US

V. Phone/Fax

Practice location:
  • Phone: 812-282-3899
  • Fax:
Mailing address:
  • Phone: 502-632-1233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number01059769A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number01059769A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: