Individual
MARK ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1964 W 11 MILE RD, BERKLEY, MI 48072-3046
(248) 544-9300
Mailing address
14680 BORGMAN ST, OAK PARK, MI 48237-1156
(248) 990-2409
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601008082
MI
Other
Enumeration date
01/22/2017
Last updated
01/22/2017
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