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General NPI Number Information
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NPI Number | 1568881746
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Entity Type | Individual
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Provider Name | SAMANTHA ROHE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 1465 S GRAND BLVD RM 2717
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City | SAINT LOUIS
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State | MO
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Zip | 63104-1003
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Country | US
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Telephone | 314-577-5634
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Fax |
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Provider Business Mailing Address
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Address Line | 423 N 40TH ST APT 6
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City | OMAHA
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State | NE
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Zip | 68131-2346
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Country | US
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Telephone | 712-301-3479
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2017008373
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License Number State | MO
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