Basic Information
Provider Information
NPI: 1477559698
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROTHMAN
FirstName: STEVEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ROTHMAN
OtherFirstName: STEPHEN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 5
Mailing Information
Address1: 100 E LANCASTER AVE
Address2: JD LANKNAU PAVILION, MEZZANINE
City: WYNNEWOOD
State: PA
PostalCode: 190963450
CountryCode: US
TelephoneNumber: 4844761000
FaxNumber: 4844769000
Practice Location
Address1: 100 E LANCASTER AVE
Address2: JD LANKNAU PAVILION, MEZZANINE
City: WYNNEWOOD
State: PA
PostalCode: 190963450
CountryCode: US
TelephoneNumber: 4844761000
FaxNumber: 4844769000
Other Information
ProviderEnumerationDate: 06/22/2005
LastUpdateDate: 06/17/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0001XMD045142LPAY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
207RC0000XMD045142LPAN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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