Individual
RICARDO A ROA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1611 27TH ST, PORTSMOUTH, OH 45662-6931
(740) 356-6836
(740) 356-6806
Mailing address
1611 27TH ST, PORTSMOUTH, OH 45662-6931
(740) 356-6836
(740) 356-6806
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
17624
WV
207Y00000X
Otolaryngology Physician
Primary
35-07-8877-R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000222804
OH MEDICAID UNISON
OH
05
—
0100708000
—
WV
05
—
0954356
—
OH
01
—
1044883
BWC
WV
01
—
1700821907
MOUTAIN STATE BC/BS
OH
01
—
310917085172
OH MEDICAID CARESOURCE
OH
01
—
P00420122
RAILROAD MEDICARE
—
Enumeration date
06/19/2006
Last updated
04/22/2026
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