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Individual

MICHAEL IAN ROTHMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
870 WAFFORD LANE, BETHLEHEM, PA 18017-3876
(216) 255-5700
(216) 255-5701
Mailing address
23625 COMMERCE PARK, SUITE 204, BEACHWOOD, OH 44122-5845
(216) 255-5700
(216) 255-5701

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
D0036911
MD
2085R0202X
Diagnostic Radiology Physician
036078872
IL
2085R0202X
Diagnostic Radiology Physician
Primary
MD039205E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017172610016
PA
01
021449XRE
PENNSYLVANIA MEDICARE
05
02906701
NY
01
043597
LICENSE
CT
05
1012411910001
PA
01
239105-1
LICENSE
NY
01
25MA08035800
LICENSE
NJ
01
881901
HIGHMARK
PA
05
8962103
NJ
01
C1-0007404
LICENSE
DE
01
D003691
LICENSE
MD
01
MD039205E
LICENSE
PA
Enumeration date
07/11/2005
Last updated
03/07/2023
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