Individual
DR. MARK RICHARD ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20950N TATUM BLVD 350, PHOENIX, AZ 85050-4256
(480) 502-6651
(480) 513-8253
Mailing address
2285 CORPORATE CIR, STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2245
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00633842
RAILROAD MEDICARE WEST DERM OF AZ
AZ
01
—
P00809240
RR MEDICARE 4/2010 UNDER PTAN DP3049
—
Enumeration date
09/11/2006
Last updated
03/16/2016
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