Healthcare Provider Details

I. General information

NPI: 1881891505
Provider Name (Legal Business Name): ROOPA DASWANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9048 SUGAR ESTATE
ST THOMAS VI
00801-1028
US

IV. Provider business mailing address

PO BOX 8028 COMMUNITY HEALTH SRMC
ST THOMAS VI
00801-1028
US

V. Phone/Fax

Practice location:
  • Phone: 340-774-7477
  • Fax:
Mailing address:
  • Phone: 340-774-7477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number569
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: