Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | KR005752 | MI |
Y | 213ER0200X | Radiology | KR005752 | MI |
NPI | 1639107378 |
---|---|
Provider Name | Dr. Kathleen Mary Rohlig |
First Address | Northville, MI 48167-1224 |
Second Address | Northville, MI 48167-1224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
122753 | CARE CHOICES (01) | MI |
950H253240 | BCBS OF MICHIGAN (01) | MI |
CH820029 | M-CARE (01) | MI |
U22426 | (02) | MI |