Individual
ROBERT BENJAMIN ROACH
Active
Individual
ROBERT BENJAMIN ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
20395
WV
2085R0202X
Diagnostic Radiology Physician
Primary
35074342
OH
2085R0202X
Diagnostic Radiology Physician
36262
KY
2085R0202X
Diagnostic Radiology Physician
MC-196
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199860
BCBS
KY
01
—
000000393352
BCBS
KY
05
—
0122863000
—
WV
05
—
2071725
—
OH
01
—
300123721
RAILROAD MEDICARE
OH
01
—
300126546
RAILROAD MEDICARE
OH
05
—
64961188
—
KY
01
—
P00254967
RAILROAD MEDICARE
KY
Enumeration date
10/28/2005
Last updated
03/25/2024
Update your record
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