Provider Demographics
NPI:1073621819
Name:ROSINSKI, STEVEN LAWRENCE (MD, PHD)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LAWRENCE
Last Name:ROSINSKI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:967 HANCOCK RD SUITE 133
Mailing Address - Street 2:
Mailing Address - City:BULLHEAD CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86442
Mailing Address - Country:US
Mailing Address - Phone:928-224-0064
Mailing Address - Fax:480-842-8608
Practice Address - Street 1:967 HANCOCK RD SUITE 133
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442
Practice Address - Country:US
Practice Address - Phone:928-224-0064
Practice Address - Fax:480-842-8608
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60001467207R00000X
WAMD 60001467207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ406031Medicaid