Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 27313 | WI |
N | 207R00000X | Internist | 27313 | WI |
N | 111NI0900X | Internist | 27313 | WI |
NPI | 1013915925 |
---|---|
Provider Name | Dr. Laurence Ross Rothstein |
First Address | Verona, WI 53593-8629 |
Second Address | Madison, WI 53715 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32896400/31584700 | (05) | WI |
E46138 | (02) | WI |