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General NPI Number Information
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NPI Number | 1487681235
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Entity Type | Individual
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Provider Name | JASON K ROSENBLUM D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 759 45TH ST STE 201
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City | MUNSTER
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State | IN
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Zip | 46321-2939
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Country | US
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Telephone | 219-836-4669
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Fax | 219-836-3046
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Provider Business Mailing Address
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Address Line | PO BOX 781076
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City | DETROIT
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State | MI
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Zip | 48278-1076
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000963A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000963A
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License Number State | IN
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