Basic Information
| Provider Information | |||||||||
| NPI: | 1184654246 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EISENBERG | ||||||||
| FirstName: | ROSANA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 GREEN HILLS VILLAGE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372152691 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6159362000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3601 TVC | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153223000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 03/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZP0101X | 35-054870 | OH | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0101X | MD44534 | TN | N | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology | 207ZP0102X | MD44534 | TN | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 000000224137 | 01 | OH | UNISON | OTHER | 4510114 | 01 | OH | AETNA | OTHER | 000000031061 | 01 | OH | ANTHEM | OTHER | 000000528744 | 01 | OH | ANTHEM | OTHER | 363501 | 01 | OH | WELLCARE | OTHER | 220017415 | 01 | OH | RAILROAD MEDICARE | OTHER | 0761055 | 05 | OH | MEDICAID | 0127464 | 01 | OH | BCMH | OTHER | 1100380 | 01 | OH | UHC | OTHER | 727393 | 01 | OH | BUCKEYE | OTHER | P00412450 | 01 | OH | RAILROAD MEDICARR | OTHER |