Individual
DR. RICHARD LEE ROTH
Active
Individual
DR. RICHARD LEE ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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