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NPI Code Detail

MEDICARE: BRIAN C ROSENAU PA-C

MEDICARE: BRIAN C ROSENAU PA-C
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
1363A00000XPhysician Assistant4446AZ

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 : 1639301948
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN C ROSENAU PA-C
Provider Business Mailing Address
First Line : PO BOX 10097
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85230-0020
Country : US
Telephone Number : 520-836-3446
Fax Number : 520-836-8807
Provider Business Practice Location Address
First Line : 205 N STUART BLVD
Second Line :
City : ELOY
State : AZ
Zip : 85131-2507
Country : US
Telephone Number : 520-466-7883
Fax Number : 520-466-3946
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 07/21/2022

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Directions to “ BRIAN C ROSENAU PA-C” Practice Location

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