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NPI Code Detail

MEDICARE: DR. FREDERICO GUILHERME ROCHA M.D.

MEDICARE: DR. FREDERICO GUILHERME ROCHA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician4301087838MI
2207VM0101XMaternal & Fetal Medicine Physician4301087838MI

General Provider Information

NPI Number : 1417149022
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICO GUILHERME ROCHA M.D.
Provider Business Mailing Address
First Line : 1 FORD PL STE 3A
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 313-874-4806
Fax Number : 313-876-1305
Provider Business Practice Location Address
First Line : 620 S FLEISHEL AVE
Second Line :
City : TYLER
State : TX
Zip : 75701-2041
Country : US
Telephone Number : 903-606-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2007
Last Update Date : 02/02/2026

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