Individual
MELVIN H ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 S CENTURY AVE, WAUNAKEE, WI 53597-2386
(608) 849-4315
(608) 850-1606
Mailing address
1300 S CENTURY AVE, WAUNAKEE, WI 53597-2386
(608) 849-4315
(608) 850-1606
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21583-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619921368
—
WI
Enumeration date
05/19/2006
Last updated
11/30/2020
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