Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 157189-1205 | UT |
NPI | 1144273905 |
---|---|
Provider Name | Dr. Thomas D Rosenberg |
First Address | Park City, UT 84060-7492 |
Second Address | Park City, UT 84060-7492 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 11/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0990205 | UNITED HEALTH CARE (01) | UT |
107005202101 | SELECT HEALTH PLANS (01) | UT |
35743 | DESERET MUTUAL INS ASSOC (01) | UT |
60843 | PUBLIC EMPLOYEES HEALTH P (01) | UT |
841433992R02 | EDUCATORS MUTUAL (01) | UT |
C63875 | (02) | UT |
QM0000040458 | ALTIUS HEALTH PLANS (01) | UT |
TPRA09041 | MOLINA (01) | UT |