Individual
ANNA ROETKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1323 W 3RD ST, DAYTON, OH 45402-6714
(937) 586-9733
(937) 586-9736
Mailing address
1323 W 3RD ST, DAYTON, OH 45402-6714
(937) 586-9733
(937) 586-9736
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.084249
OH
207R00000X
Internal Medicine Physician
38933
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2519064
—
OH
05
—
64085798
—
KY
01
—
P00148383
RAILROAD MEDICARE
KY
01
—
P00823721
RAILROAD MEDICARE
KY
Enumeration date
06/09/2006
Last updated
09/16/2015
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