MEDICARE: DR. MELVIN ROAT 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	207W00000X	Ophthalmology Physician	MD033859E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	524894	OTHER	PA	MEDICARE GROUP NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0000 1930655	OTHER	PA	UNITED HEALTHCARE
2	1151931	OTHER	PA	AETNA HMO
3	2632612000	OTHER	PA	KEYSTONE

General Provider Information

NPI Number	:	1881681278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN ROAT M.D.

Provider Business Mailing Address
First Line	:	1019 STANFORD DR
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-2031
Country	:	US
Telephone Number	:	610-446-2260
Fax Number	:	610-446-3360

Provider Business Practice Location Address
First Line	:	1098 W BALTIMORE PIKE STE 3407
Second Line	:
City	:	MEDIA
State	:	PA
Zip	:	19063-5139
Country	:	US
Telephone Number	:	610-566-7127
Fax Number	:	610-566-0793

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	11/12/2024

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Directions to “ DR. MELVIN ROAT M.D.” Practice Location

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