Provider Demographics
NPI:1760431407
Name:HUNTER, ROSE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:MARIE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 KIMOLE LN
Mailing Address - Street 2:SUITE B-1
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1491
Mailing Address - Country:US
Mailing Address - Phone:517-263-6733
Mailing Address - Fax:517-263-7148
Practice Address - Street 1:901 KIMOLE LN
Practice Address - Street 2:SUITE B-1
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1491
Practice Address - Country:US
Practice Address - Phone:517-263-6733
Practice Address - Fax:517-263-7148
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRH070913208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5450691OtherAETNA
MI18632OtherHEALTH PLAN OF MI
MI117198OtherCARE CHOICE
MI119775OtherGREAT LAKES OF MI
MI04412OtherPARAMOUNT
MI4586332Medicaid
MIOM28420017Medicare ID - Type Unspecified
MI04412OtherPARAMOUNT