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Individual

MR. RICHARD W ROZELLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
5175 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49525-1048
(616) 363-9833
(616) 363-9701
Mailing address
4540 KALAMAZOO AVE SE, KENTWOOD, MI 49508-4625
(616) 281-0666
(616) 281-0752

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901001069
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1266510002
ADMINISTAR
MI
05
3506847
MI
01
480026387
RAILROAD MEDICARE
MI
Enumeration date
06/24/2006
Last updated
11/08/2011
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