Individual
MICHAEL ROOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
6711
AZ
363AM0700X
Medical Physician Assistant
Primary
PA0347
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477655223
—
NV
01
—
70003254
RAILROAD MEDICARE
NV
01
—
PA0347
NV STATE MEDICAL LICENSE
NV
Enumeration date
09/02/2006
Last updated
03/17/2018
Update your record
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