Organization
RICHARD L ROTH MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LEE ROTH MD (PRESIDENT)
(703) 821-2337
Entity
Organization
Contact information
Practice address
6845 ELM STREET, SUITE 210, MCLEAN, VA 22101-3822
(703) 821-2337
Mailing address
6845 ELM STREET, SUITE 210, MCLEAN, VA 22101-3822
(703) 821-2337
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101028447
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010255155
—
VA
01
—
059999
ANTHEM BCBS
VA
01
—
8555
CARE FIRST BCBS
DC
Enumeration date
09/20/2006
Last updated
08/19/2008
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