Provider Demographics
NPI:1679630628
Name:ROSENZWEIG, SETH DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:DANIEL
Last Name:ROSENZWEIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N LEWIS ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70563-2046
Mailing Address - Country:US
Mailing Address - Phone:337-367-1444
Mailing Address - Fax:337-367-1445
Practice Address - Street 1:500 N LEWIS ST
Practice Address - Street 2:SUITE 280
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70563-2046
Practice Address - Country:US
Practice Address - Phone:337-367-1444
Practice Address - Fax:337-367-1445
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.026070207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1052001Medicaid
LA4M197DE05Medicare PIN
P00749932Medicare PIN