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1063406197

NPI Code Detail

MEDICARE: EDWARD STEVEN ROSENTHAL MD

MEDICARE: EDWARD STEVEN ROSENTHAL 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	207R00000X	Internal Medicine Physician	35-053841	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	357410002	OTHER	OH	CARESOURCE
2	000000189978	OTHER	OH	UNICARE
3	000000189978	OTHER	OH	ANTHEM BLUE SHIELD
4	533832	OTHER	OH	ADVANTRA FREEDOM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	4041169	OTHER	OH	AETNA
7	T53841	OTHER	OH	SUMMACARE HEALTH PLAN

General Provider Information

NPI Number	:	1063406197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD STEVEN ROSENTHAL MD

Provider Business Mailing Address
First Line	:	12000 MCCRACKEN RD
Second Line	:	#453
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2933
Country	:	US
Telephone Number	:	216-581-4900
Fax Number	:	216-581-7370

Provider Business Practice Location Address
First Line	:	12000 MCCRACKEN RD
Second Line	:	#453
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2933
Country	:	US
Telephone Number	:	216-581-4900
Fax Number	:	216-581-7370

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

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	11/29/2007

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Directions to “ EDWARD STEVEN ROSENTHAL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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