Healthcare Provider Details

I. General information

NPI: 1881980621
Provider Name (Legal Business Name): PAUL ROTHCHILD N/A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PAUL NIEDZWIECKI N/A

II. Dates (important events)

Enumeration Date: 06/21/2011
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 COLUMBIA AVE E STE 211
BATTLE CREEK MI
49015-3761
US

IV. Provider business mailing address

171 WESTCHESTER WAY
BATTLE CREEK MI
49015-8691
US

V. Phone/Fax

Practice location:
  • Phone: 626-372-0317
  • Fax: 269-231-4372
Mailing address:
  • Phone: 626-372-0317
  • Fax: 269-230-3053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code229N00000X
TaxonomyAnaplastologist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: