MEDICARE: DR. ANA MARIA ROTAR 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
1	2084P0800X	Psychiatry Physician	4301086747	MI

General Provider Information

NPI Number	:	1710188529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA MARIA ROTAR M.D.

Provider Business Mailing Address
First Line	:	26901 BEAUMONT BLVD STE 3D
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48033-3849
Country	:	US
Telephone Number	:	947-522-1861
Fax Number	:	947-522-0307

Provider Business Practice Location Address
First Line	:	1101 WEST UNIVERSITY DRIVE
Second Line	:	BEHAVIORAL HEALTH CENTER, 6 WEST
City	:	ROCHESTER
State	:	MI
Zip	:	48307-1831
Country	:	US
Telephone Number	:	248-652-5291
Fax Number	:	248-652-5817

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	07/27/2022

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