Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | D30667 | MD |
NPI | 1215925474 |
---|---|
Provider Name | Mark S Rosenthal |
First Address | Baltimore, MD 21209-2230 |
Second Address | Baltimore, MD 21209-2230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2005 |
Last Update Date | 06/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D74421 | (02) |