Individual
DR. DAVID BURTON ROAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2343
(215) 831-4600
(215) 831-4700
Mailing address
4641 ROOSEVELT BLVD, PHILADELPHIA, PA 19124-2398
(215) 831-4600
(215) 831-4700
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
OS008990L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017602440001
—
PA
01
—
D08036000
CONTROLLED DRUG SUBSTANCE
NH
Enumeration date
12/08/2006
Last updated
12/19/2017
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