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Individual

DR. KATIE MARIE ROSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
19991 HALL RD STE 201, MACOMB, MI 48044
(586) 228-0150
Mailing address
20952 E 12 MILE RD STE 200, SAINT CLAIR SHORES, MI 48081-3203
(586) 771-4820
(586) 771-6620

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5101020639
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E06273
BCBSM
MI
01
CB9133
RAILROAD MEDICARE
MI
Enumeration date
06/30/2013
Last updated
06/27/2018
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