Individual
MATTHEW WILLIAM ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5225
(740) 441-8097
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5225
(740) 441-8097
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
23441
WV
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
35.083418
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000241633
OH MEDICAID MOLINA
OH
05
—
2444000
—
OH
01
—
310917085189
OH MEDICAID CARESOURCE
OH
05
—
3810002080
—
WV
Enumeration date
12/21/2006
Last updated
02/09/2015
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