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Individual

KARLA JEAN ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3860 MONROE RD, DE PERE, WI 54115-8399
(920) 496-4700
(920) 431-1967
Mailing address
3860 MONROE RD, DE PERE, WI 54115-8399
(920) 496-4700

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37108
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
32183200
WI
Enumeration date
07/10/2006
Last updated
09/24/2019
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