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Individual
DR. AMELIA BOGART ROTH
Active
Individual
DR. AMELIA BOGART ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD155302
OR
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD155302
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD155302
MEDICAL LICENSE
OR
Enumeration date
12/05/2008
Last updated
08/19/2019
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