Provider Demographics
NPI:1053557223
Name:ROC & ASSOCIATES M. D. , P. C.
Entity type:Organization
Organization Name:ROC & ASSOCIATES M. D. , P. C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:MATAS
Authorized Official - Last Name:ROC
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:734-459-7630
Mailing Address - Street 1:8554 N CANTON CENTER RD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1310
Mailing Address - Country:US
Mailing Address - Phone:734-459-7630
Mailing Address - Fax:734-459-1035
Practice Address - Street 1:8554 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1310
Practice Address - Country:US
Practice Address - Phone:734-459-7630
Practice Address - Fax:734-459-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-18
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
40306552OtherAETNA
MI3089029 TYPE 10Medicaid
MI0H25056OtherBLUE CROSS BLUE SHIELD
MI3089029 TYPE 10Medicaid