Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 26761 | MN |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 26761 | MN |
NPI | 1215916929 |
---|---|
Provider Name | Michael G Rock |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 03/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
571819800 | (05) | MN |
D81917 | (02) |