Provider Demographics
NPI:1457323198
Name:ROSMANN, MICHAEL R (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:ROSMANN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 7TH ST
Mailing Address - Street 2:STE C MICHAEL R ROSMANN PHD
Mailing Address - City:HARLAN
Mailing Address - State:IA
Mailing Address - Zip Code:51537
Mailing Address - Country:US
Mailing Address - Phone:712-235-6100
Mailing Address - Fax:712-235-6105
Practice Address - Street 1:1210 7TH ST
Practice Address - Street 2:STE C MICHAEL R ROSMANN PHD
Practice Address - City:HARLAN
Practice Address - State:IA
Practice Address - Zip Code:51537
Practice Address - Country:US
Practice Address - Phone:712-235-6100
Practice Address - Fax:712-235-6105
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA320103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI6749Medicare ID - Type Unspecified