Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 0414905 | KS |
NPI | 1235245853 |
---|---|
Provider Name | Dr. Thomas F Rosenberg |
First Address | Eastborough, KS 67208-4426 |
Second Address | Wichita, KS 67206-2911 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 23/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AR6052423 | DEA (01) | |
B68447 | (02) |