Individual
DR. BRUCE JOSEPH ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5225 MID AMERICA PLZ, DIV IM MEDICAL ONCOLOGY, STE D115, SAINT LOUIS, MO 63129-0002
(800) 647-2098
(314) 362-3192
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(800) 647-2098
(314) 362-3192
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
2010008626
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204198808
—
MO
Enumeration date
05/15/2007
Last updated
04/17/2025
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