Healthcare Provider Details

I. General information

NPI: 1912130451
Provider Name (Legal Business Name): YARON ROTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 11/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER DR BUILDING 10, ROOM 9C434
BETHESDA MD
20892-1800
US

IV. Provider business mailing address

10 CENTER DR BUILDING 10, ROOM 9C434
BETHESDA MD
20892-1800
US

V. Phone/Fax

Practice location:
  • Phone: 301-451-6553
  • Fax: 301-402-0491
Mailing address:
  • Phone: 301-451-6553
  • Fax: 301-402-0491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License NumberMD437620
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: