Provider Demographics
NPI:1699667519
Name:ROSSER, MARKES LEE
Entity type:Individual
Prefix:
First Name:MARKES
Middle Name:LEE
Last Name:ROSSER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 E 119TH ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2871
Mailing Address - Country:US
Mailing Address - Phone:216-327-5054
Mailing Address - Fax:
Practice Address - Street 1:5210 E 119TH ST
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2871
Practice Address - Country:US
Practice Address - Phone:216-327-5054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver