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General NPI Number Information
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NPI Number | 1598935447
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Entity Type | Organization
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Legal Business Name | MELVIN I. ROAT, MD, LLC
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 09/13/2020
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Provider Practice Location Address
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Address Line | 100 E LANCASTER AVE STE 430
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City | WYNNEWOOD
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State | PA
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Zip | 19096-3426
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Country | US
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Telephone | 610-645-5755
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Fax | 610-566-1744
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Provider Business Mailing Address
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Address Line | 1019 STANFORD DR
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City | WYNNEWOOD
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State | PA
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Zip | 19096-2031
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Country | US
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Telephone | 610-645-5755
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Fax | 610-645-0264
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. MELVIN I ROAT
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Credential | MD
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Telephone | 610-645-5755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD033859E
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License Number State | PA
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