Individual
ELMER DEJESUS ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
337 ST LUKES DR, MONTGOMERY, AL 36117-7102
(334) 356-1411
(334) 356-1578
Mailing address
337 ST LUKES DRIVE, MONTGOMERY, AL 36117-7102
(334) 356-1411
(334) 356-1578
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00022416
AL
208000000X
Pediatrics Physician
Primary
00022416
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009910176
—
AL
05
—
392055922
—
AL
01
—
51060553
BCBS
AL
01
—
515165531
BCBS
AL
01
—
51516953
BCBS
AL
05
—
6309000054
—
AL
05
—
630901054
—
AL
05
—
630902054
—
AL
05
—
630903054
—
AL
01
—
P00040942
RAILROAD
AL
Enumeration date
07/23/2006
Last updated
03/30/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us