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General NPI Number Information
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NPI Number | 1790749000
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Entity Type | Individual
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Provider Name | EUGENE RONTAL MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 06/21/2022
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Provider Practice Location Address
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Address Line | 33533 W 12 MILE RD STE 190
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City | FARMINGTON HILLS
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State | MI
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Zip | 48331-5636
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Country | US
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Telephone | 248-865-3327
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Fax | 248-737-0636
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Provider Business Mailing Address
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Address Line | 33533 W 12 MILE RD STE 190
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City | FARMINGTON HILLS
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State | MI
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Zip | 48331-5636
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Country | US
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Telephone | 248-865-3327
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Fax | 248-737-0636
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 4301028146
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License Number State | MI
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