Individual
EDWARD H. ROTHBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10150 SE 32ND AVE, MILWAUKIE, OR 97222-6516
(503) 513-8300
Mailing address
PO BOX 3158, PROVIDENCE MILWAUKIE HOSPITAL, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD26662
OR
208M00000X
Hospitalist Physician
Primary
MD26662
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00451467
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
04/24/2006
Last updated
11/12/2021
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