MEDICARE: DR. JOAN O ROTHENBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	173000000X	Legal Medicine	35043347R	OH
2	207P00000X	Emergency Medicine Physician	35-043347	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00949838	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033158662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN O ROTHENBERG MD

Provider Business Mailing Address
First Line	:	18181 PEARL RD
Second Line	:
City	:	STRONGSVILLE
State	:	OH
Zip	:	44136-6949
Country	:	US
Telephone Number	:	440-816-6414
Fax Number	:	440-816-6421

Provider Business Practice Location Address
First Line	:	18181 PEARL RD
Second Line	:
City	:	STRONGSVILLE
State	:	OH
Zip	:	44136-6949
Country	:	US
Telephone Number	:	440-816-6414
Fax Number	:	440-816-6421

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	03/05/2012

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Directions to “ DR. JOAN O ROTHENBERG MD” Practice Location

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