Provider Demographics
NPI:1447662762
Name:ROSENBAUM, ERIC MARC (DO)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:MARC
Last Name:ROSENBAUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 HAGGERTY RD STE 1010
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2185
Mailing Address - Country:US
Mailing Address - Phone:248-668-0900
Mailing Address - Fax:248-926-9112
Practice Address - Street 1:2300 HAGGERTY RD STE 1010
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2185
Practice Address - Country:US
Practice Address - Phone:248-668-0900
Practice Address - Fax:248-926-9112
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021129207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine