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General NPI Number Information
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NPI Number | 1912261686
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Entity Type | Individual
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Provider Name | DANA ELISE ROCKWELL D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 10/08/2019
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Provider Practice Location Address
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Address Line | 1701 SOUTH BLVD E STE 110
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6118
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Country | US
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Telephone | 248-853-0803
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Fax | 248-852-5859
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Provider Business Mailing Address
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Address Line | 1701 SOUTH BLVD E STE 140
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-6118
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Country | US
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Telephone | 248-853-0803
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Fax | 248-852-5859
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 5101019930
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License Number State | MI
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