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Individual

JAMES E ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9055 SPRINGBROOK DR NW, COON RAPIDS, MN 55433-5841
(763) 780-9155
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
52048
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
MN
Enumeration date
07/22/2008
Last updated
08/06/2024
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