Basic Information
| Provider Information | |||||||||
| NPI: | 1063513554 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROSENSTEIN | ||||||||
| FirstName: | ALEXANDER | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3100 MACCORKLE SEAVE 900 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 253041223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043883580 | ||||||||
| FaxNumber: | 3043883585 | ||||||||
| Practice Location | |||||||||
| Address1: | 415 MORRIS STREET, | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CHARLESTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042064155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 12/21/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 25141 | WV | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 202000040 | 05 | NM | MEDICAID | 44370768 | 05 | NM | MEDICAID | 81158S | 01 | TX | BC/BS | OTHER | 141007101 | 01 | TX | FIRSTCARE COMMERCIAL | OTHER | 200058000A | 05 | OK | MEDICAID | 166813902 | 05 | TX | MEDICAID | 166813903 | 05 | TX | MEDICAID | 141007102 | 05 | TX | MEDICAID | 87916Z | 01 | TX | HMO BLUE | OTHER | 8R7014 | 01 | TX | BCBSTX | OTHER | 166813904 | 05 | TX | MEDICAID | 202000040 | 01 | NM | PRESBYTERIAN COMMERCIAL | OTHER | 450686CE02700 | 01 | TX | SECTION 1011 | OTHER | B128 | 01 | NM | TRIWEST | OTHER |