Provider Demographics
NPI:1760547277
Name:ROSENBERG, SANFORD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:MICHAEL
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7603 FOREST AVE
Mailing Address - Street 2:SUITE # 301
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4942
Mailing Address - Country:US
Mailing Address - Phone:804-285-9700
Mailing Address - Fax:804-285-9745
Practice Address - Street 1:7603 FOREST AVE
Practice Address - Street 2:SUITE # 301
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4942
Practice Address - Country:US
Practice Address - Phone:804-285-9700
Practice Address - Fax:804-285-9745
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA32002207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB60177Medicare UPIN