Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD5934 | DC |
NPI | 1689752917 |
---|---|
Provider Name | Kenneth N Rosenbaum |
First Address | Atlanta, GA 30374-4785 |
Second Address | Washington, DC 20010-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 30/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D78154 | (02) |