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Individual
GARY E ROSENTHAL
Active
Individual
GARY E ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32370
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0174623
—
IA
01
—
48551
WELLMARK BCBS
IA
Enumeration date
11/18/2005
Last updated
12/17/2007
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