Healthcare Provider Details

I. General information

NPI: 1649212325
Provider Name (Legal Business Name): JAMES R ROTRAMEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 02/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

IV. Provider business mailing address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-9011
  • Fax: 636-239-0433
Mailing address:
  • Phone: 636-239-9011
  • Fax: 636-239-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number118260
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: