Individual
ETHAN ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
MD61053243
WA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
125066820
IL
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
DR.0066499
CO
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
MD61053243
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831585041
—
WA
Enumeration date
04/14/2015
Last updated
09/23/2021
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