Provider Demographics
NPI:1790721223
Name:ROESEN, HOWARD MICHAEL (DPM)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MICHAEL
Last Name:ROESEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1600 E GUDE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1496
Mailing Address - Country:US
Mailing Address - Phone:301-933-7133
Mailing Address - Fax:757-591-0552
Practice Address - Street 1:754 MCGUIRE PL
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23601-1630
Practice Address - Country:US
Practice Address - Phone:757-599-5710
Practice Address - Fax:757-591-0552
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA103-000869213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery