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General NPI Number Information
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NPI Number | 1588226005
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Entity Type | Individual
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Provider Name | DAWN MICHELLE NATASHA ROACH MD
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Gender | Female
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Dates
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Enumeration Date | 07/04/2019
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Last Update Date | 09/08/2024
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Provider Practice Location Address
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Address Line | 16681 S DUPONT HWY
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City | HARRINGTON
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State | DE
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Zip | 19952-3191
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Country | US
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Telephone | 302-398-8704
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Fax | 302-398-8818
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Provider Business Mailing Address
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Address Line | 640 S. STATE ST., MAIL CODE 3055
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City | DOVER
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State | DE
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Zip | 19901
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Country | US
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Telephone | 302-398-8704
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Fax | 302-398-8818
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C1-0026569
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | C1-0026569
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License Number State | DE
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