Healthcare Provider Details

I. General information

NPI: 1609830033
Provider Name (Legal Business Name): DAWN N ROSSER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13750 S SEDONA PKWY STE 2
LANSING MI
48906-8101
US

IV. Provider business mailing address

804 SERVICE RD STE A109B
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-353-4000
  • Fax: 844-722-4112
Mailing address:
  • Phone: 517-353-4000
  • Fax: 844-722-4112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301074298
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: