MEDICARE: MICHAEL L. ROTHMAN, M.D., P.C.

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
1	207X00000X	Orthopaedic Surgery Physician	70-77	NM

General Provider Information

NPI Number	:	1427535384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL L. ROTHMAN, M.D., P.C.

Provider Business Mailing Address
First Line	:	PO BOX 22340
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87502-2340
Country	:	US
Telephone Number	:	505-988-9783
Fax Number	:	505-988-5830

Provider Business Practice Location Address
First Line	:	2945 RODEO PARK DR E UNIT 6
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-6312
Country	:	US
Telephone Number	:	505-988-9783
Fax Number	:	505-988-5830

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL L. ROTHMAN
Credential	:	MD
Telephone Number	:	505-988-9783

Provider Enumeration Date	:	07/24/2018
Last Update Date	:	07/24/2018

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