Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | D61615 | MD |
NPI | 1437289139 |
---|---|
Provider Name | Melissa Rosenberg |
First Address | East Lansing, MI 48824-7015 |
Second Address | Lansing, MI 48912-1800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 26/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1437289139 | (05) | MI |
I39885 | (02) | MI |