Individual
DAVID L ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 HERITAGE WAY, #2100, KALISPELL, MT 59901-3158
(406) 257-8992
(406) 257-8996
Mailing address
350 HERITAGE WAY, #2100, KALISPELL, MT 59901-3158
(406) 257-8992
(406) 257-8996
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
7895
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36218
—
MT
01
—
593
BLUE CROSS
MT
01
—
M011000969
MEDICARE PTAN
MT
Enumeration date
06/08/2006
Last updated
01/03/2013
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