Provider Demographics
NPI:1548287055
Name:ROSENBLUTH, DANIEL B (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:ROSENBLUTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-8917
Mailing Address - Fax:314-454-7524
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM PULMONARY AND CCM, 8TH FL
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-454-8917
Practice Address - Fax:314-454-7524
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO101454207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO206993313Medicaid
MO206993313Medicaid
IL$$$$$$$$$Medicaid
MO981010183Medicare PIN