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General NPI Number Information
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NPI Number | 1538285564
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Entity Type | Organization
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Legal Business Name | CHARLES ROSENBAUM MD PC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 65 FREMONT ST
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City | MARLBOROUGH
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State | MA
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Zip | 01752-1271
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Country | US
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Telephone | 508-481-4213
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Fax | 508-481-7841
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Provider Business Mailing Address
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Address Line | 65 FREMONT ST
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City | MARLBOROUGH
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State | MA
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Zip | 01752-1271
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Country | US
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Telephone | 508-481-4213
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Fax | 508-481-7841
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES ROSENBAUM
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Credential | M.D.
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Telephone | 508-481-4213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 36848
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License Number State | MA
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