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General NPI Number Information
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NPI Number | 1568406627
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Entity Type | Individual
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Provider Name | JOHN GALLOWAY ROTH D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 2 EAST ROLLING CROSSROADS SUITE 55
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City | CATONSVILLE
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State | MD
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Zip | 21228-6212
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Country | US
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Telephone | 410-455-9660
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Fax | 410-455-9665
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Provider Business Mailing Address
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Address Line | 1 N MAIN ST
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City | BEL AIR
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State | MD
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Zip | 21014-3592
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Country | US
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Telephone | 410-879-1212
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Fax | 410-803-1859
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00679
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 00679
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License Number State | MD
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