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General NPI Number Information
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NPI Number | 1790770550
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Entity Type | Individual
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Provider Name | MICHELE A. ROELLI MD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | MEMORIAL HOSPITAL OF LAFAYETTE COUNTY 800 CLAY ST
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City | DARLINGTON
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State | WI
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Zip | 53530-1228
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Country | US
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Telephone | 608-776-4466
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Fax | 608-776-5777
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Provider Business Mailing Address
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Address Line | MEMORIAL HSOPITAL OF LAFAYETTE COUNTY 800 CLAY ST
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City | DARLINGTON
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State | WI
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Zip | 53530-1228
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Country | US
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Telephone | 608-776-4466
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Fax | 608-776-5777
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 44873-020
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 44873
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License Number State | WI
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