Healthcare Provider Details

I. General information

NPI: 1164616819
Provider Name (Legal Business Name): WAYNE M. ROZRAN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 05/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 SOLOMONS ISLAND RD N
PRINCE FREDERICK MD
20678-3926
US

IV. Provider business mailing address

220 SOLOMONS ISLAND RD N
PRINCE FREDERICK MD
20678-3926
US

V. Phone/Fax

Practice location:
  • Phone: 410-535-4884
  • Fax: 410-535-4509
Mailing address:
  • Phone: 410-535-4884
  • Fax: 410-535-4509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WAYNE M. ROZRAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-535-4884