Provider Demographics
NPI:1154341071
Name:ROJEWSKI, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:ROJEWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BYRON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1007
Mailing Address - Country:US
Mailing Address - Phone:517-546-0200
Mailing Address - Fax:517-546-3218
Practice Address - Street 1:1200 BYRON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1007
Practice Address - Country:US
Practice Address - Phone:517-546-0200
Practice Address - Fax:517-546-4669
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073031207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1154341071Medicaid
MI080F360200OtherBCBSM GROUP PIN
MI080F360200OtherBCBSM GROUP PIN
MI1154341071Medicaid
MI111454OtherBLUE CARE NETWORK
MI131637OtherPREFERRED CHOICES
MI718292OtherAETNA
MIH39429OtherHAP
MI0D76226010Medicare ID - Type UnspecifiedMEDICARE
MI4323073Medicaid