Individual
MARK RICHARD ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 540, PORTLAND, OR 97213
(503) 215-6600
(503) 215-7751
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD12332
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288098
—
OR
01
—
P00957616
RR MEDICARE
OR
Enumeration date
10/23/2006
Last updated
03/24/2021
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