| Ellen M. Rotblatt, M.d., P.c. | |
|
705 South Main Street Suite 280 Plymouth MI 48170-2089 | |
| (734) 454-3560 | |
| (734) 454-3570 |
| Full Name | Ellen M. Rotblatt, M.d., P.c. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 705 South Main Street, Plymouth, Michigan |
| Authorized Official Name and Position | Ellen M Rotblatt (PRESIDENT, BOARD CERTIFIED PSYCHIAT) |
| Authorized Official Contact | 7344543560 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen M. Rotblatt, M.d., P.c. 705 South Main Street Suite 280 Plymouth MI 48170-2089 Ph: (734) 454-3560 | Ellen M. Rotblatt, M.d., P.c. 705 South Main Street Suite 280 Plymouth MI 48170-2089 Ph: (734) 454-3560 |
| NPI Number | 1578596110 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 12/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578596110 | NPI | - | NPPES |
| 11287336 | Other | MI | CAQH |
| 4301052943 | Other | MI | MEDICAL LICENSE NUMBER MI |
| 2084P0800X | Other | MI | MEDICAL DR. TAXONOMY # |
| F16401 | Other | MI | MEDICARE OPTED-OUT UPIN |
| 193400000X | Other | MI | NPI SINGLE SPECIALTY TAXONOMY NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301052943 (Michigan) | Primary |
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