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NPI Code Detail

MEDICARE: MICHAEL ROSEN

MEDICARE: MICHAEL ROSEN
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
1207X00000XOrthopaedic Surgery Physician02005783AIN
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1639419971
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ROSEN
Provider Business Mailing Address
First Line : 5050 N CLINTON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5886
Country : US
Telephone Number : 260-484-8551
Fax Number : 260-482-5060
Provider Business Practice Location Address
First Line : 5050 N CLINTON ST
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-5886
Country : US
Telephone Number : 260-484-8551
Fax Number : 260-482-5060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2013
Last Update Date : 02/17/2026

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Directions to “ MICHAEL ROSEN ” Practice Location

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