Individual
DR. DAVID GORDON ROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 N WABASH AVE, SUITE 440, MARION, IN 46952-2600
(765) 664-7401
(765) 664-7428
Mailing address
330 N WABASH AVE, SUITE 440, MARION, IN 46952-2600
(765) 664-7401
(765) 664-7428
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01027484
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091655
BLUE CROSS BLUE SHIELD
IN
01
—
2214331001
CIGNA
IN
01
—
4576108
AETNA
IN
Enumeration date
07/06/2006
Last updated
03/03/2008
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