Provider Demographics
NPI:1710026315
Name:MICHAEL X ROHAN MD PA
Entity Type:Organization
Organization Name:MICHAEL X ROHAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:X
Authorized Official - Last Name:ROHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-769-5400
Mailing Address - Street 1:408 W 19TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4602
Mailing Address - Country:US
Mailing Address - Phone:850-769-5400
Mailing Address - Fax:
Practice Address - Street 1:408 W 19TH ST
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4602
Practice Address - Country:US
Practice Address - Phone:850-769-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAB948OtherMEDICARE ID
FLAB948OtherMEDICARE ID