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Individual

MR. ANDREW R. ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
(336) 716-3202

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
157007
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
3205
NC
367500000X
Certified Registered Nurse Anesthetist
NA06830
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2342245
OH
05
8051449
NC
Enumeration date
07/10/2006
Last updated
03/30/2021
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