Provider Demographics
NPI:1336135748
Name:ROTHMAN, WARREN I
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:ROTHMAN
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 OSLER DR
Mailing Address - Street 2:SUITE 507
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7736
Mailing Address - Country:US
Mailing Address - Phone:410-296-0540
Mailing Address - Fax:410-296-0541
Practice Address - Street 1:7505 OSLER DR
Practice Address - Street 2:SUITE 507
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7736
Practice Address - Country:US
Practice Address - Phone:410-296-0540
Practice Address - Fax:410-296-0541
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0022009207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC48964Medicare UPIN
MD7221Medicare ID - Type Unspecified