Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 28064 | WI |
NPI | 1689640773 |
---|---|
Provider Name | Michael J Rock |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 28/01/2022 |