Provider Demographics
NPI:1023085784
Name:ROESLER, HUGO K (MD)
Entity type:Individual
Prefix:
First Name:HUGO
Middle Name:K
Last Name:ROESLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2712 TALIESIN DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2015
Mailing Address - Country:US
Mailing Address - Phone:269-344-8700
Mailing Address - Fax:269-344-8199
Practice Address - Street 1:1141 S ROSE ST
Practice Address - Street 2:SUITE A
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2652
Practice Address - Country:US
Practice Address - Phone:269-344-8700
Practice Address - Fax:269-344-8199
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301026293207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI10 30606OtherPHYSICIANS HEALTH PLAN
MI12126OtherHEALTH PLAN OF MI
MI10 1352590Medicaid
MI0397452Medicare ID - Type Unspecified
MI12126OtherHEALTH PLAN OF MI