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NPI Code Detail

MEDICARE: STEVEN R ROTH MD

MEDICARE: STEVEN R ROTH MD
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
1207Q00000XFamily Medicine PhysicianMD11109RI

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 : 1750311296
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN R ROTH MD
Provider Business Mailing Address
First Line : PO BOX 2153 DEPT 40338
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35287-9386
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 RIVER ST
Second Line :
City : WAKEFIELD
State : RI
Zip : 02879-3214
Country : US
Telephone Number : 401-783-0523
Fax Number : 401-783-9448
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2006
Last Update Date : 08/20/2020

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