Provider Demographics
NPI:1538188487
Name:ROSENBLUM, NORMAN G (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:G
Last Name:ROSENBLUM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE STE 661
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3437
Mailing Address - Country:US
Mailing Address - Phone:610-649-8085
Mailing Address - Fax:610-649-8984
Practice Address - Street 1:100 E LANCASTER AVE STE 661
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096
Practice Address - Country:US
Practice Address - Phone:610-649-8085
Practice Address - Fax:610-649-8984
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-022580-E207VX0000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2228106Medicaid
PA000882959Medicaid
PA165933Medicare PIN