Provider Demographics
NPI:1699808121
Name:ROSENBERG, MARC J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:J
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5838 HARBOUR VIEW BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23435-2663
Mailing Address - Country:US
Mailing Address - Phone:757-541-1050
Mailing Address - Fax:757-541-1097
Practice Address - Street 1:5838 HARBOUR VIEW BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-2663
Practice Address - Country:US
Practice Address - Phone:757-541-1050
Practice Address - Fax:757-541-1097
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2011-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101241501207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X993M06Medicare PIN