Provider Demographics
NPI:1023223260
Name:ROSEBROCK, CRAIG NEALE (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:NEALE
Last Name:ROSEBROCK
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:PULMONOLGY, SLEEP, ASTHAM, AND ALLERGY CENTER OF DUBLIN
Mailing Address - Street 2:100 MEDICAL DRIVE, SUITE 300
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021
Mailing Address - Country:US
Mailing Address - Phone:478-272-3209
Mailing Address - Fax:478-272-2283
Practice Address - Street 1:201 HOSPITAL RD
Practice Address - Street 2:APPARTMENT UU1
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2408
Practice Address - Country:US
Practice Address - Phone:770-720-6325
Practice Address - Fax:404-851-6325
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2008-01380207RP1001X
GA072650207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC58866UMedicare UPIN