Provider Demographics
NPI:1942513320
Name:MICHEL ORTEGA, ROSA MAYELA (MD)
Entity Type:Individual
Prefix:
First Name:ROSA
Middle Name:MAYELA
Last Name:MICHEL ORTEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:201 SIVLEY RD SW
Mailing Address - Street 2:STE 200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5177
Mailing Address - Country:US
Mailing Address - Phone:256-265-1822
Mailing Address - Fax:256-265-1825
Practice Address - Street 1:201 SIVLEY RD SW
Practice Address - Street 2:STE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5177
Practice Address - Country:US
Practice Address - Phone:256-265-1822
Practice Address - Fax:256-265-1825
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34767207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL263544Medicaid
ALA11821L138OtherMEDICARE PTAN
ALQ00029724OtherRAILROAD MEDICARE