Individual
DARYL A ROSENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200000602
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
200000602
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10187516
—
VA
01
—
1280M
BCBS
—
01
—
182521
MEDCOST
—
01
—
22596
PARTNERS
—
05
—
3810002729
—
WV
01
—
7558309
AETNA
—
05
—
891280M
—
NC
01
—
P00300135
RR MEDICARE
—
05
—
Q0060J
—
SC
Enumeration date
11/30/2005
Last updated
03/25/2014
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