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Individual

PAUL S ROSENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1373 E SR 62, MADISON, IN 47250
(812) 801-0848
(812) 801-0774
Mailing address
PO BOX 3395, EVANSVILLE, IN 47732-3395

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01035954
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000042209
ANTHEM BCBS
IN
05
100149010A
IN
01
1073893
PASSPORT KY MEDICAID
KY
01
200034109
MEDICARE RAILROAD
01
2435128000
PASSPORT ADVANTAGE
KY
01
410014P
SIHO
IN
01
4370893
AETNA
05
64759699
KY
Enumeration date
07/13/2006
Last updated
06/22/2018
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