Individual
DR. BERNIE V ROTTACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2204 COMMERCE BLVD, MOUND, MN 55364-1547
(952) 472-3937
(952) 472-7487
Mailing address
2204 COMMERCE BLVD, MOUND, MN 55364-1547
(952) 472-3937
(952) 472-7487
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1546
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074944300
—
MN
01
—
144L5RO
BLUE CROSS & BLUE SHIELD OF MN
MN
01
—
200111404
HEALTHPARTNERS
MN
01
—
2100307
MEDICA EYEWEAR
MN
01
—
214140663001
PREFERRED ONE
MN
01
—
2201983
MEDICA EXAM
MN
Enumeration date
06/08/2005
Last updated
05/08/2008
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