Individual
LAURA S ROSENBAUM-BLOOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4101 MAIN STREET, SUITE C, HILTON HEAD ISLAND, SC 29926
(843) 342-6000
(843) 342-6001
Mailing address
4101 MAIN STREET, SUITE C, HILTON HEAD ISLAND, SC 29926
(843) 342-6000
(843) 342-6001
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
22334
SC
2084P0804X
Child & Adolescent Psychiatry Physician
22334
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22334
MEDICAL LICENSE
SC
Enumeration date
03/15/2007
Last updated
03/21/2012
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