Provider Demographics
NPI:1366803454
Name:WALCH, ROSEMARIE E (DO)
Entity type:Individual
Prefix:
First Name:ROSEMARIE
Middle Name:E
Last Name:WALCH
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Gender:F
Credentials:DO
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Mailing Address - Street 1:819 N SHIAWASSEE ST STE 110
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-1601
Mailing Address - Country:US
Mailing Address - Phone:989-723-1390
Mailing Address - Fax:989-725-1415
Practice Address - Street 1:819 N SHIAWASSEE ST STE 110
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-1601
Practice Address - Country:US
Practice Address - Phone:989-723-1390
Practice Address - Fax:989-725-1415
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2024-01-26
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Provider Licenses
StateLicense IDTaxonomies
MI51010251012084N0400X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1366803454Medicaid