Individual
DR. DOUGLAS C ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 LEW DEWITT BLVD, WAYNESBORO, VA 22980
(540) 332-5162
(540) 332-5875
Mailing address
6 ROAD 7586, BLOOMFIELD, NM 87413-4934
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101256332
VA
207Q00000X
Family Medicine Physician
D0040014
MD
207Q00000X
Family Medicine Physician
MD044326E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100728880
—
PA
05
—
3810006043
—
WV
05
—
482501200
—
MD
Enumeration date
07/01/2005
Last updated
05/03/2016
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