Provider Demographics
NPI:1346408952
Name:ROSENOW, JUSTIN RONALD NEWTON (DO)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:RONALD NEWTON
Last Name:ROSENOW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LAUREL ST
Mailing Address - Street 2:SUITE 3170
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3017
Mailing Address - Country:US
Mailing Address - Phone:515-283-0463
Mailing Address - Fax:515-283-0794
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:SUITE 3170
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3017
Practice Address - Country:US
Practice Address - Phone:515-283-0463
Practice Address - Fax:515-283-0794
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA4462207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology