Provider Demographics
NPI:1639106594
Name:ROLLINS, DAVID LITTLETON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LITTLETON
Last Name:ROLLINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36060 EUCLID AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4656
Mailing Address - Country:US
Mailing Address - Phone:440-269-8346
Mailing Address - Fax:440-975-5763
Practice Address - Street 1:36060 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4656
Practice Address - Country:US
Practice Address - Phone:440-269-8346
Practice Address - Fax:440-975-5763
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350581202086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0733326Medicaid
OH0645157Medicare ID - Type UnspecifiedMEDICARE ID
OH0733326Medicaid