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General NPI Number Information
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NPI Number | 1356547673
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Entity Type | Individual
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Provider Name | ASHLEY ANN ROTH MD
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Gender | Female
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Dates
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Enumeration Date | 06/24/2007
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 2300 OPITZ BLVD
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City | WOODBRIDGE
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State | VA
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Zip | 22191-3311
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Country | US
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Telephone | 703-670-1364
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 S VEITCH ST APT 409
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City | ARLINGTON
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State | VA
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Zip | 22206-3064
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Country | US
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Telephone | 561-670-4471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101249548
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License Number State | VA
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