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Individual

TRENTON D ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
550 UNIVERSITY BLVD, ROOM 0641, INDIANAPOLIS, IN 46202-5149
(317) 278-2449
(317) 278-2803
Mailing address
250 N SHADELAND AVE, SUITE 130, INDIANAPOLIS, IN 46219-4959
(317) 963-0860

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01066196A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200945970
IN
Enumeration date
06/30/2008
Last updated
02/03/2021
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