Provider Demographics
NPI:1053486936
Name:ROSSMAN, MITCHELL CHARLES (DPM)
Entity Type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:CHARLES
Last Name:ROSSMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 VALLEY VIEW RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-8906
Mailing Address - Country:US
Mailing Address - Phone:814-355-1850
Mailing Address - Fax:814-355-8909
Practice Address - Street 1:930 BELLEFONTE AVE
Practice Address - Street 2:STE 103
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2749
Practice Address - Country:US
Practice Address - Phone:570-660-9358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-23
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005592213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011578480002Medicaid
PARO1634067OtherHIGHMARK BCBS
PA1011578480002Medicaid
PAV01987Medicare UPIN