Individual
DR. MICHAEL ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1060 CHESTNUT ST, ANN ARBOR, MI 48104-2824
(734) 975-0001
Mailing address
1060 CHESTNUT ST, ANN ARBOR, MI 48104-2824
(734) 975-0001
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301034106
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301034106
MEDICAL LICENSE
MI
Enumeration date
08/17/2007
Last updated
08/17/2007
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