Provider Demographics
NPI:1518951839
Name:ROSMAN, PAUL MARTIN (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MARTIN
Last Name:ROSMAN
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 1:4551 PENNSYLVANIA AVE UNIT 1301
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3399
Mailing Address - Country:US
Mailing Address - Phone:216-409-6066
Mailing Address - Fax:816-508-5861
Practice Address - Street 1:4321 WASHINGTON ST STE 6100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5901
Practice Address - Country:US
Practice Address - Phone:816-932-3470
Practice Address - Fax:816-932-3492
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70762207RE0101X
OH34-00-3867-R207RE0101X
NY106048207RE0101X
MO2017005141207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0605232Medicaid
OHAR3513517OtherDEA#
OH0605232Medicaid
OHRD0585761Medicare ID - Type Unspecified