Provider Demographics
NPI:1326008004
Name:ROSENBERG, JOEL BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:BENJAMIN
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W SONDLEY DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1154
Mailing Address - Country:US
Mailing Address - Phone:828-253-1482
Mailing Address - Fax:828-258-2589
Practice Address - Street 1:445 BILTMORE AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4565
Practice Address - Country:US
Practice Address - Phone:828-253-1482
Practice Address - Fax:828-258-2589
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24287174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8973187Medicaid
NCC81191Medicare UPIN
NC202305Medicare ID - Type Unspecified