MEDICARE: DR. RONALD WILLIAM ROSENBERG 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	2084P0015X	Psychosomatic Medicine Physician	46516	MI

General Provider Information

NPI Number	:	1568680866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD WILLIAM ROSENBERG MD

Provider Business Mailing Address
First Line	:	6431 INKSTER RD
Second Line	:	SUITE 226
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-1310
Country	:	US
Telephone Number	:	248-602-0011
Fax Number	:	888-391-5251

Provider Business Practice Location Address
First Line	:	6431 INKSTER RD
Second Line	:	SUITE 226
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-1310
Country	:	US
Telephone Number	:	248-602-0011
Fax Number	:	888-391-5251

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

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	03/15/2017

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