Provider Demographics
NPI:1184654246
Name:EISENBERG, ROSANA (MD)
Entity Type:Individual
Prefix:
First Name:ROSANA
Middle Name:
Last Name:EISENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:
Practice Address - Street 1:3601 TVC
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-322-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-054870207ZP0101X
TNMD44534207ZP0101X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000224137OtherUNISON
OH4510114OtherAETNA
OH000000031061OtherANTHEM
OH000000528744OtherANTHEM
OH363501OtherWELLCARE
OH220017415OtherRAILROAD MEDICARE
OH0761055Medicaid
OH0127464OtherBCMH
OH1100380OtherUHC
OH727393OtherBUCKEYE
OHP00412450OtherRAILROAD MEDICARR
OH1100380OtherUHC
OH000000224137OtherUNISON
OH220017415OtherRAILROAD MEDICARE