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NPI Code Detail

MEDICARE: STEVEN A ROODMAN M.D.

MEDICARE: STEVEN A ROODMAN 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
1207L00000XAnesthesiology Physician036108956IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00068429OTHERILRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720064439
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN A ROODMAN M.D.
Provider Business Mailing Address
First Line : PO BOX 503256
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63150-0001
Country : US
Telephone Number : 660-826-5960
Fax Number : 660-826-4852
Provider Business Practice Location Address
First Line : 3333 W DEYOUNG ST
Second Line :
City : MARION
State : IL
Zip : 62959-5884
Country : US
Telephone Number : 618-998-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 04/24/2009

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Directions to “ STEVEN A ROODMAN M.D.” Practice Location

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