Healthcare Provider Details

I. General information

NPI: 1124043799
Provider Name (Legal Business Name): GEORGE M. ROIG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 COLLIERS WAY
WEIRTON WV
26062-5014
US

IV. Provider business mailing address

401 MARKET ST SUITE 1000
STEUBENVILLE OH
43952-2881
US

V. Phone/Fax

Practice location:
  • Phone: 304-797-6266
  • Fax:
Mailing address:
  • Phone: 740-284-1775
  • Fax: 740-284-1749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35037121R
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number09848
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD032829E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: