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NPI Code Detail

MEDICARE: MR. DAVID MICHAEL ROSSWOG

MEDICARE: MR. DAVID MICHAEL ROSSWOG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorPC003165PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1489402OTHERPAVALUEOPTIONS
21482984OTHERPAHIGHMARK
37601520OTHERPAAETNA

General Provider Information

NPI Number : 1053392274
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAVID MICHAEL ROSSWOG
Provider Business Mailing Address
First Line : 1330 W 26TH ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1402
Country : US
Telephone Number : 814-451-2317
Fax Number : 814-454-7780
Provider Business Practice Location Address
First Line : 1330 W 26TH ST
Second Line :
City : ERIE
State : PA
Zip : 16508-1402
Country : US
Telephone Number : 814-451-2317
Fax Number : 814-454-7780
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 07/08/2007

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Directions to “ MR. DAVID MICHAEL ROSSWOG ” Practice Location

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