Provider Demographics
NPI:1538201215
Name:ROSEMAN, BARRY B (DMD MD)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:B
Last Name:ROSEMAN
Suffix:
Gender:M
Credentials:DMD MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 BROOKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9536
Mailing Address - Country:US
Mailing Address - Phone:302-229-7973
Mailing Address - Fax:
Practice Address - Street 1:730 BROOKWOOD LN
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9536
Practice Address - Country:US
Practice Address - Phone:302-764-7714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00008931223S0112X
DEC1-0002254207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000443701Medicaid