Provider Demographics
NPI:1134101645
Name:TROSCH, RICHARD M (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:TROSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:26400 W 12 MILE RD
Mailing Address - Street 2:STE 110
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-1700
Mailing Address - Country:US
Mailing Address - Phone:248-355-3875
Mailing Address - Fax:248-355-3857
Practice Address - Street 1:26400 W 12 MILE RD
Practice Address - Street 2:STE 110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1700
Practice Address - Country:US
Practice Address - Phone:248-355-3875
Practice Address - Fax:248-355-3857
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43014074602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E62955Medicare UPIN
OF36135Medicare ID - Type Unspecified