Provider Demographics
NPI:1831434455
Name:ROSENBERG, ERAN (MD)
Entity type:Individual
Prefix:
First Name:ERAN
Middle Name:
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950202
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0202
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:3999 DUTCHMANS LN STE 6
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4744
Practice Address - Country:US
Practice Address - Phone:502-394-1999
Practice Address - Fax:502-394-1999
Is Sole Proprietor?:No
Enumeration Date:2012-12-07
Last Update Date:2023-04-06
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Provider Licenses
StateLicense IDTaxonomies
KY476122088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK158730Medicare PIN