Organization
PRIZM ANESTHESIA ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ROSENBERG MD (AUTHORIZED OFFICIAL)
(224) 231-4363
Entity
Organization
Contact information
Practice address
6200 N HAGGERTY RD, CANTON, MI 48187-3605
(734) 526-8860
Mailing address
PO BOX 33661, DETROIT, MI 48232-5661
(224) 231-4363
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
5101016547
IL
208VP0000X
Pain Medicine Physician
Primary
4301056069
IL
Other
Enumeration date
05/09/2016
Last updated
08/29/2016
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