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Individual

DR. JACK MICHAEL ROSENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
325 E EISENHOWER PKWY, SUITE 100, ANN ARBOR, MI 48108-3364
(734) 936-7175
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301051728
MI
207LP2900X
Pain Medicine (Anesthesiology) Physician
4301051728
MI
207P00000X
Emergency Medicine Physician
4301051728
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3069240
MI
Enumeration date
10/05/2006
Last updated
01/05/2009
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