Rose Demczuk MD PLLC

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

4301058105 Issued in MI

Legal business name

ROSE DEMCZUK MD PLLC

Practice address

7267 Taft Rd
Bruce TWP, MI 48065-3619

Phone

(248) 688-8057

Fax

(248) 601-9991

NPI assigned

Sep 2, 2010

Last updated

Nov 18, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Rose Demczuk, MDNPI 1639237522

Title

Owner

Phone

(248) 688-8057

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rose H Demczuk, MD

  • Psychiatry Physician
  • Rochester Hills, MI
  • NPI 1639237522
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290038400000",
    "number": "1619284320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7267 TAFT RD",
            "city": "BRUCE TWP",
            "state": "MI",
            "postal_code": "480653619",
            "telephone_number": "248-688-8057",
            "fax_number": "248-601-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7267 TAFT RD",
            "city": "BRUCE TWP",
            "state": "MI",
            "postal_code": "480653619",
            "telephone_number": "248-688-8057",
            "fax_number": "248-601-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE DEMCZUK MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-11-18",
        "status": "A",
        "authorized_official_last_name": "DEMCZUK",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-688-8057",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "4301058105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Precision Blu Health LLC
• Proactive MD Mi PLLC (Proactive MD-L&L Health Center)
• Rachel Rodorigo PLLC
• Julia Marie Ramaci
• Rachel Marie Rodorigo, PSYD.
• Rebecca Sanders
• Kendra Kay Smith, LMSW
• Maddison K Smith, FNP-BC
• Deborah Ann Stys, MS
• Joanne Marie Talarek, RN, MSN, C-ANP

• Clinical Neuropsychologist in Bruce TWP, MI
• Providers in Bruce TWP, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.