Provider Demographics
NPI:1649255217
Name:ROSMAN, DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:ROSMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5821 W MAPLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2275
Mailing Address - Country:US
Mailing Address - Phone:248-855-0407
Mailing Address - Fax:248-855-1323
Practice Address - Street 1:5821 W MAPLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2275
Practice Address - Country:US
Practice Address - Phone:248-855-0407
Practice Address - Fax:248-855-1323
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301047592207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI110F375900OtherBLUE SHIELD
MI0632683OtherBCBS INDIVIDUAL
MI110202018OtherRR MEDICARE
MI1649255217Medicaid
MI1649255217Medicaid
MIB47475Medicare UPIN