Provider Demographics
NPI:1023292786
Name:MICHAEL J ROSNER, MD PA
Entity type:Organization
Organization Name:MICHAEL J ROSNER, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ROSNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:828-684-1076
Mailing Address - Street 1:80 DOCTORS DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-7290
Mailing Address - Country:US
Mailing Address - Phone:828-684-1076
Mailing Address - Fax:828-684-7857
Practice Address - Street 1:80 DOCTORS DR
Practice Address - Street 2:SUITE 4
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-7289
Practice Address - Country:US
Practice Address - Phone:828-684-1076
Practice Address - Fax:828-684-7857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-18
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26865174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900126Medicaid
NC2344780Medicare PIN
NCC74579Medicare UPIN