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Organization

HERBERT J ROTH AND KALPANA SHAH MD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HERBERT J ROTH SR. MD (PRESIDENT)
(248) 644-5626
Entity
Organization

Contact information

Practice address
31815 SOUTHFIELD RD, STE 14, BEVERLY HILLS, MI 48025-5471
(248) 644-5626
(248) 644-5497
Mailing address
31815 SOUTHFIELD RD, STE 14, BEVERLY HILLS, MI 48025-5471
(248) 644-5626
(248) 644-5497

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
024195
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3289487
MI
05
3289496
MI
Enumeration date
12/11/2006
Last updated
08/22/2020
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