MEDICARE: DR. WILLIAM M ROETHEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD2006-0621	NM
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	4301054529	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	WR054529	OTHER	MI	BC/BS OF MI

General Provider Information

NPI Number	:	1669433017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM M ROETHEL M.D.

Provider Business Mailing Address
First Line	:	601 MARTIN LUTHER KING AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-3619
Country	:	US
Telephone Number	:	505-727-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 MARTIN LUTHER KING AVE NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-3619
Country	:	US
Telephone Number	:	505-727-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2006
Last Update Date	:	01/23/2025

Similar Medicare Providers

1215525902 — AUGUST VOJDANI PA-C
Practice Location Address:

4588 PARADISE BLVD NW , MEDICARE ADVANTAGE CLINIC
ALBUQUERQUE, NM
87114-4105

Practice Phone: 505-998-1840
Practice Fax: 505-998-1841

1548553209 — DR. RYAN MICHAEL URICH M.D.
Practice Location Address:

601 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE, NM
87102-3619

Practice Phone: 505-727-8326
Practice Fax:

1508863721 — DR. SOUHEIL H SAMAHA
Practice Location Address:

601 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE, NM
87102-3619

Practice Phone: 505-727-3170
Practice Fax:

1346220456 — CHARLES HADDAD MD
Practice Location Address:

601 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE, NM
87102-3619

Practice Phone: 505-727-7096
Practice Fax: 505-727-7099

1407824972 — JEFFREY HEBERT MD
Practice Location Address:

601 DR MARTIN LUTHER KING JR AVE NE , LOVELACE MEDICAL CENTER
ALBUQUERQUE, NM
87102-3619

Practice Phone: 505-298-0301
Practice Fax: 505-554-3302

1972549970 — MILA BERDECIA MD
Practice Location Address:

601 DR MARTIN LUTHER KING JR AVE NE
ALBUQUERQUE, NM
87102-3619

Practice Phone: 407-754-8195
Practice Fax:

Directions to “ DR. WILLIAM M ROETHEL M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.