Provider Demographics
NPI:1518170406
Name:RAPHAEL, MICHAEL ROCK (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROCK
Last Name:RAPHAEL
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Gender:M
Credentials:DO
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Mailing Address - Street 1:30055 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3230
Mailing Address - Country:US
Mailing Address - Phone:248-985-5000
Mailing Address - Fax:248-985-5500
Practice Address - Street 1:30055 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3230
Practice Address - Country:US
Practice Address - Phone:248-985-5000
Practice Address - Fax:248-985-5500
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2020-10-07
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Provider Licenses
StateLicense IDTaxonomies
MI5101016523207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology