Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | SC005592 | PA |
NPI | 1053486936 |
---|---|
Provider Name | Dr. Mitchell Charles Rossman |
First Address | Bellefonte, PA 16823-8906 |
Second Address | Lock Haven, PA 17745-2749 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2006 |
Last Update Date | 26/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1011578480002 | (05) | PA |
RO1634067 | HIGHMARK BCBS (01) | PA |
V01987 | (02) | PA |