Individual
DR. RICHARD LEE ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6845 ELM ST, STE 210, MC LEAN, VA 22101-3822
(703) 821-2337
Mailing address
6845 ELM ST, STE 210, MC LEAN, VA 22101-3822
(703) 821-2337
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101028447
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059999
ANTHEM BC BS
VA
01
—
215112
MAMSI
VA
01
—
8555
CAREFILRST BC BS
VA
Enumeration date
05/27/2005
Last updated
10/01/2008
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