Provider Demographics
NPI:1467552828
Name:ROSENBERG, STEPHEN NATHAN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NATHAN
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7784
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66207-0784
Mailing Address - Country:US
Mailing Address - Phone:913-424-9670
Mailing Address - Fax:913-851-4430
Practice Address - Street 1:4940 W 137TH STREET
Practice Address - Street 2:SUITE B
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66224
Practice Address - Country:US
Practice Address - Phone:913-424-9670
Practice Address - Fax:913-851-4430
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0529541208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSR42D293Medicare PIN
H58446Medicare UPIN