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Individual

DR. MITCHELL BRUCE ROTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14825 N OUTER 40 RD, STE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
(314) 336-2640
Mailing address
14825 N OUTER 40 RD, STE 200, CHESTERFIELD, MO 63017-2152
(314) 336-2555
(314) 336-2640

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
R3L27
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
202833513
MO
Enumeration date
06/01/2005
Last updated
01/20/2011
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