Individual
CHARLES R. ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2701 W NORTH ST, MUNCIE, IN 47303-3415
(765) 448-8000
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01035252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100106830
—
IN
Enumeration date
01/26/2006
Last updated
03/15/2021
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