Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | ME88295 | FL |
N | 207RP1001X | Pulmonary Disease | ME88295 | FL |
NPI | 1043268436 |
---|---|
Provider Name | Matthew J. Rossing |
First Address | Kentwood, MI 49508-5008 |
Second Address | Kalamazoo, MI 49007-5341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 09/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
275693500 | (05) | FL |
I57404 | (02) |