Organization
NORTHERN NEUROSURGERY GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A ROVIN MD (PARTNER)
(906) 225-4575
Entity
Organization
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-4575
Mailing address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-4575
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
4301057445
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140E26312
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
01/19/2006
Last updated
08/22/2020
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