Provider Demographics
NPI:1326097551
Name:ROSENBLOOM, RICHARD C (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:C
Last Name:ROSENBLOOM
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 1:1350 LOCUST ST
Mailing Address - Street 2:SUITE100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4738
Mailing Address - Country:US
Mailing Address - Phone:412-242-3787
Mailing Address - Fax:
Practice Address - Street 1:1350 LOCUST ST STE 208
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-886-9803
Practice Address - Fax:412-886-1918
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025618E207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010214440009Medicaid
PA182541GK7Medicare ID - Type Unspecified
PAB40812Medicare UPIN