Healthcare Provider Details

I. General information

NPI: 1518951839
Provider Name (Legal Business Name): PAUL MARTIN ROSMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4321 WASHINGTON ST STE 6100
KANSAS CITY MO
64111-5901
US

IV. Provider business mailing address

4551 PENNSYLVANIA AVE UNIT 1301
KANSAS CITY MO
64111-3399
US

V. Phone/Fax

Practice location:
  • Phone: 816-932-3470
  • Fax: 816-932-3492
Mailing address:
  • Phone: 216-409-6066
  • Fax: 816-508-5861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number70762
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number34-00-3867-R
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number106048
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number2017005141
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: