Individual
DR. WILLIAM DOUGLAS ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
10466
MS
2085R0202X
Diagnostic Radiology Physician
Primary
10466
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00122418
—
MS
01
—
1861428351
GROUP NPI
—
01
—
C00475
GROUP MEDICARE UPIN
—
Enumeration date
08/09/2006
Last updated
08/25/2009
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