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General NPI Number Information
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NPI Number | 1336114537
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Entity Type | Organization
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Legal Business Name | SPECIALISTS IN REHABILITATION MEDICINE PC
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1135 W UNIVERSITY DR STE 175
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City | ROCHESTER
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State | MI
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Zip | 48307-1893
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Country | US
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Telephone | 248-650-5861
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Fax | 248-650-5865
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Provider Business Mailing Address
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Address Line | 1135 W UNIVERSITY DR STE 175
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City | ROCHESTER
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State | MI
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Zip | 48307-1893
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Country | US
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Telephone | 248-650-5861
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Fax | 248-650-5865
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN MICHAEL ROTH
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Credential | M.D.
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Telephone | 248-650-5861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301052881
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301066288
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301062365
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 4301055982
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License Number State | MI
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