Individual
DARRELL S ROELANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3443 FARR RD, FRUITPORT, MI 49415-8779
(231) 672-2900
(231) 672-2901
Mailing address
PO BOX 1848, MUSKEGON, MI 49443-1848
(231) 672-2900
(231) 672-2901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101015219
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N28430036
MEDICARE PTAN
MI
Enumeration date
01/19/2006
Last updated
12/22/2021
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