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Organization

JOSE P DELA ROSA MD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE P DELA ROSA MD (MEDICAL DIRECTOR)
(231) 779-9960
Entity
Organization

Contact information

Practice address
203 PALUSTER STREET, CADILLAC, MI 49601
(231) 779-9960
(231) 779-8945
Mailing address
203 PALUSTER STREET, CADILLAC, MI 49601
(231) 779-9960
(231) 779-8945

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301052242
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CK6820
RAILROAD MEDICARE
MI
Enumeration date
08/16/2007
Last updated
02/27/2008
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