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Individual

MELVIN C ROOF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
800 W JEFFERSON ST, NORTHEAST REGIONAL MEDICAL CENTER, KIRKSVILLE, MO 63501-1443
(660) 785-1000
(660) 785-1237
Mailing address
PO BOX 702, KIRKSVILLE, MO 63501-0702
(660) 785-1000
(660) 785-1237

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
36957
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050072810
RAILROAD MEDICARE
05
0976845
IA
05
242695948
MO
05
2970012
IA
01
80173
HEALTHCARE USA
MO
01
8298
HEALTHCARE USA (GROUP)
MO
01
CG4336
RAILROAD MEDICARE
Enumeration date
07/14/2006
Last updated
11/16/2010
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