Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 15659 | SC |
NPI | 1124087101 |
---|---|
Provider Name | Mr. Daniel L Rosner |
First Address | Myrtle Beach, SC 29572 |
Second Address | Myrtle Beach, SC 29572 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
156592 | (05) | SC |
F41393 | (02) |