Provider Demographics
NPI:1437328523
Name:IRA ROSENSHEIN MD PHD LLC
Entity Type:Organization
Organization Name:IRA ROSENSHEIN MD PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSENSHEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:843-408-4709
Mailing Address - Street 1:4 SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7444
Mailing Address - Country:US
Mailing Address - Phone:843-408-4709
Mailing Address - Fax:843-795-8755
Practice Address - Street 1:4 SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7444
Practice Address - Country:US
Practice Address - Phone:843-408-4709
Practice Address - Fax:843-795-8755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty