Provider Demographics
NPI:1790050151
Name:ROSOL, DEREK R (DO)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:R
Last Name:ROSOL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:4660 S HAGADORN RD STE 500
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6804
Mailing Address - Country:US
Mailing Address - Phone:517-432-6144
Mailing Address - Fax:517-432-6150
Practice Address - Street 1:3700 52ND ST SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49512-9637
Practice Address - Country:US
Practice Address - Phone:616-656-3700
Practice Address - Fax:616-656-3701
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2023-07-20
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Provider Licenses
StateLicense IDTaxonomies
MI5101021468204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM