Provider Demographics
NPI:1811303787
Name:WHELAN, ROS JOSEPH (MB BCH BAO)
Entity type:Individual
Prefix:DR
First Name:ROS
Middle Name:JOSEPH
Last Name:WHELAN
Suffix:
Gender:M
Credentials:MB BCH BAO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8155 E FAIRMOUNT DR
Mailing Address - Street 2:2228
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-6839
Mailing Address - Country:US
Mailing Address - Phone:720-561-1986
Mailing Address - Fax:
Practice Address - Street 1:3901 BEAUBIEN ST # 2
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2119
Practice Address - Country:US
Practice Address - Phone:313-833-4490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315229424207T00000X
CO390200000X
MI4301505866207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program