Individual
ELISABETH S ROTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9000 MENTOR AVE STE 105, MENTOR, OH 44060-4497
(440) 947-4404
(440) 947-4419
Mailing address
PO BOX 8792, BELFAST, ME 04915-8792
(440) 974-4404
(440) 974-4419
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35078189
OH
207RR0500X
Rheumatology Physician
Primary
35078189
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2182810
—
OH
Enumeration date
09/16/2006
Last updated
01/13/2021
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