Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | D0063348 | MD |
N | 208800000X | Urologist | MD035492 | DC |
NPI | 1003809310 |
---|---|
Provider Name | Mark Rosenblum |
First Address | Owings Mills, MD 21117-5437 |
Second Address | Bethesda, MD 20817-7822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2005 |
Last Update Date | 08/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
872104100 | (05) | MD |
I36611 | (02) | MD |