Provider Demographics
NPI:1639493554
Name:ROHAL, MICHAEL J (RN)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:ROHAL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8642 WHIPPORWILL RD
Mailing Address - Street 2:
Mailing Address - City:RAVENNA
Mailing Address - State:OH
Mailing Address - Zip Code:44266-8508
Mailing Address - Country:US
Mailing Address - Phone:330-654-2889
Mailing Address - Fax:
Practice Address - Street 1:8642 WHIPPORWILL RD
Practice Address - Street 2:
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266-8508
Practice Address - Country:US
Practice Address - Phone:330-654-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.276959163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice