Provider Demographics
NPI:1851431472
Name:ROZAS, VICTOR VLADIMIRO (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:VLADIMIRO
Last Name:ROZAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1604
Mailing Address - Country:US
Mailing Address - Phone:989-463-5287
Mailing Address - Fax:989-463-2540
Practice Address - Street 1:201 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1604
Practice Address - Country:US
Practice Address - Phone:989-463-5287
Practice Address - Fax:989-463-2540
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI034417207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47030Medicare UPIN