Individual
MICHAEL J ROSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-7874
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35-078069
OH
208C00000X
Colon & Rectal Surgery Physician
036172387
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000209909
UNISON
OH
01
—
000000503714
ANTHEM
—
01
—
1629098322
MICHIGAN MEDICAID
MI
05
—
2264937
—
OH
01
—
363966
WELLCARE
OH
01
—
738090
BUCKEYE
OH
01
—
7967609
AETNA
—
01
—
P00240176
RAILROAD MEDICARE
OH
01
—
P00353691
RAILROAD MEDICARE
OH
Enumeration date
07/19/2006
Last updated
12/05/2024
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