MEDICARE: DR. ALAN H. ROSENBAUM 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	2084P0800X	Psychiatry Physician	4301027031	MI

General Provider Information

NPI Number	:	1629042528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN H. ROSENBAUM MD

Provider Business Mailing Address
First Line	:	6689 ORCHARD LAKE RD # 308
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3404
Country	:	US
Telephone Number	:	248-539-0200
Fax Number	:	248-539-0987

Provider Business Practice Location Address
First Line	:	2619 KINGSTOWNE DR
Second Line	:
City	:	COMMERCE TWP
State	:	MI
Zip	:	48390-2712
Country	:	US
Telephone Number	:	248-539-0200
Fax Number	:	248-539-0987

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

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	11/16/2023

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