Provider Demographics
NPI:1841249422
Name:ROZIN, DEBRA A (MD)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:ROZIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:23250 MERCANTILE RD
Mailing Address - Street 2:STE 140
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5928
Mailing Address - Country:US
Mailing Address - Phone:216-464-4646
Mailing Address - Fax:216-464-4695
Practice Address - Street 1:3619 PARK EAST DR
Practice Address - Street 2:SUITE 110
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4330
Practice Address - Country:US
Practice Address - Phone:216-464-4646
Practice Address - Fax:216-464-4695
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2016-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35062474207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP00705993OtherRRCARE
OH0918707Medicaid
F55951Medicare UPIN
OH0738205Medicare PIN
OH7365661Medicare PIN