Provider Demographics
NPI:1972248763
Name:ROHL, CHRISTIAN DIETER (DO)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:DIETER
Last Name:ROHL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E MICHIGAN AVE STE 101B
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-2109
Mailing Address - Country:US
Mailing Address - Phone:517-364-3850
Mailing Address - Fax:
Practice Address - Street 1:1322 E MICHIGAN AVE STE 101B
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-2109
Practice Address - Country:US
Practice Address - Phone:517-364-3850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151015754APP22207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine