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General NPI Number Information
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NPI Number | 1831434455
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Entity Type | Individual
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Provider Name | ERAN ROSENBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/07/2012
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 3999 DUTCHMANS LN STE 6
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City | LOUISVILLE
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State | KY
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Zip | 40207-4744
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Country | US
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Telephone | 502-394-1999
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Fax | 502-394-1999
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Provider Business Mailing Address
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Address Line | PO BOX 950202
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City | LOUISVILLE
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State | KY
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Zip | 40295-0202
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 47612
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License Number State | KY
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