Healthcare Provider Details

I. General information

NPI: 1851431472
Provider Name (Legal Business Name): VICTOR VLADIMIRO ROZAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 ORCHARD ST
ALMA MI
48801-1604
US

IV. Provider business mailing address

201 ORCHARD ST
ALMA MI
48801-1604
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-5287
  • Fax: 989-463-2540
Mailing address:
  • Phone: 989-463-5287
  • Fax: 989-463-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number034417
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: