Individual
DR. JEROME ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28625 NORTHWESTERN HWY, SUITE 223, SOUTHFIELD, MI 48034-1828
(248) 350-3190
(248) 350-3245
Mailing address
28625 NORTHWESTERN HWY, SUITE 223, SOUTHFIELD, MI 48034-1828
(248) 350-3190
(248) 350-3245
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
4301036655
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0630127
BCBS INDIVIDUAL
MI
01
—
109680
CARE-PREFERRED CHOICES
MI
05
—
4639329
—
MI
01
—
C1393
M'CARE
MI
Enumeration date
12/07/2005
Last updated
07/08/2007
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