Individual
KONSTANTIN ROSICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-6000
Mailing address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-6000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5151016417
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5151016417
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS
MI
Enumeration date
05/05/2022
Last updated
07/27/2023
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