Healthcare Provider Details

I. General information

NPI: 1861194219
Provider Name (Legal Business Name): MICHELLE ELIZABETH FLOHR ROZANSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 HAWKS LN NE
BROOKHAVEN GA
30329-2283
US

IV. Provider business mailing address

1968 HAWKS LN NE
BROOKHAVEN GA
30329-2283
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3350
  • Fax: 404-778-6901
Mailing address:
  • Phone: 404-778-3350
  • Fax: 404-778-6901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number113285
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number113285
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: