Individual
DR. PAUL BRYAN ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
221 NORTHVIEW DR, CHESAPEAKE, VA 23322-4041
(757) 953-2544
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036113684
IL
2086X0206X
Surgical Oncology Physician
Primary
036113684
IL
2086X0206X
Surgical Oncology Physician
56692
VA
Other
Enumeration date
09/05/2008
Last updated
12/23/2024
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