| Doctor Name: | DR. MICHAEL ROLLI |
| NPI Number: | 1669586582 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | MD0000048561 |
| Business Practice Address: | Shape Hcf Unit 21414 Box 153 Apo, AE - 09705 |
| Business Phone Number: | 0113265443321 |
| Business Fax Number: | 0113265445882 |
| Mailing Address: | Shape Hcf Unit 21414, Box 153 APO |
| State: | AE |
| Postal Code: | 09705 |
| Phone Number: | 003265443321 |
| Fax Number: | 03265445882 |
| NPI Enumeration Date: | 08/18/2006 |
| NPI Last Update Date: | 06/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD0000048561 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |