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NPI Code Detail

MEDICARE: DR. RALPH JOEL ROTHENBERG M.D.

MEDICARE: DR. RALPH JOEL ROTHENBERG M.D.
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
1207RR0500XRheumatology Physician35044671ROH

Other Identifiers

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

General Provider Information

NPI Number : 1548266190
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RALPH JOEL ROTHENBERG M.D.
Provider Business Mailing Address
First Line : 500 GYPSY LN
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1315
Country : US
Telephone Number : 330-884-4740
Fax Number : 330-884-4738
Provider Business Practice Location Address
First Line : 500 GYPSY LN
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1315
Country : US
Telephone Number : 330-884-4740
Fax Number : 330-884-4738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 10/18/2007

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