Individual
JASON G. ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2350 N LAKE DR STE 300, MILWAUKEE, WI 53211-4528
(414) 298-7100
(414) 298-7101
Mailing address
1121 E NORTH AVE, MILWAUKEE, WI 53212-3515
(414) 267-6502
(414) 267-3892
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
44786
WI
207Q00000X
Family Medicine Physician
44786
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336179340
—
WI
Enumeration date
07/04/2006
Last updated
09/07/2021
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