Organization
ELLEN M. ROTBLATT, M.D., P.C.
Active
Organization
ELLEN M. ROTBLATT, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN M ROTBLATT M.D. (PRESIDENT, BOARD CERTIFIED PSYCHIAT)
(734) 454-3560
Entity
Organization
Contact information
Practice address
705 SOUTH MAIN STREET, SUITE 280, PLYMOUTH, MI 48170-2089
(734) 454-3560
(734) 454-3570
Mailing address
705 SOUTH MAIN STREET, SUITE 280, PLYMOUTH, MI 48170-2089
(734) 454-3560
(734) 454-3570
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301052943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11287336
CAQH
MI
01
—
193400000X
NPI SINGLE SPECIALTY TAXONOMY NUMBER
MI
01
—
2084P0800X
MEDICAL DR. TAXONOMY #
MI
01
—
4301052943
MEDICAL LICENSE NUMBER MI
MI
01
—
F16401
MEDICARE OPTED-OUT UPIN
MI
Enumeration date
07/08/2006
Last updated
12/01/2011
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