Most Relevant Information
Provider Data
| NPI Number: | 1003265208 |
| Provider Name: | MICHAEL ROCCO SHROADS M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/08/2016 |
| Last Updated: | 06/10/2022 |
Provider Practice Location
10101 ERNST ROAD
ROANOKE
IN
467839710
Practice Location Phone/Fax
| Phone: | 2602345401 |
| Fax: |
Provider Mailing Location
250 N SHADELAND AVE
INDIANAPOLIS
IN
462194959
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |