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Individual

DR. WILLIAM M ROETHEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
601 MARTIN LUTHER KING AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-8000
Mailing address
601 MARTIN LUTHER KING AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 727-8000

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2006-0621
NM
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301054529
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103311354
MI
01
WR054529
BC/BS OF MI
MI
Enumeration date
03/28/2006
Last updated
01/23/2025
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