Individual
DANA MARIE ROQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, SUITE S3AX-31, BALTIMORE, MD 21201-1544
(667) 214-1302
(410) 328-3379
Mailing address
250 W PRATT ST, SUITE 880, BALTIMORE, MD 21201-2423
(667) 214-1302
(410) 328-3379
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
MT 191169
PA
207VX0201X
Gynecologic Oncology Physician
049475
CT
207VX0201X
Gynecologic Oncology Physician
Primary
D0078133
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324852600
—
MD
Enumeration date
06/16/2007
Last updated
05/31/2016
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