Provider Demographics
NPI:1982005914
Name:ROSENBERG, HARVEY DAVID
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:DAVID
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-4720
Mailing Address - Country:US
Mailing Address - Phone:410-524-5101
Mailing Address - Fax:410-524-5398
Practice Address - Street 1:12001 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-4720
Practice Address - Country:US
Practice Address - Phone:410-524-5101
Practice Address - Fax:410-524-5398
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist