Individual
DR. STEPHEN M ROE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
979 E 3RD ST, STE 300, CHATTANOOGA, TN 37403-2136
(423) 267-0466
(423) 778-8168
Mailing address
979 E 3RD ST, STE 300, CHATTANOOGA, TN 37403-2136
(423) 267-0466
(423) 778-8168
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD20301
TN
208600000X
Surgery Physician
Primary
MD20301
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00456057F
—
GA
05
—
009204010
—
AL
01
—
020041422
RR MEDICARE
—
01
—
122398
BCBS OF TN
—
01
—
1740070
UHC
—
01
—
2587123 001
CIGNA
—
01
—
62165877402
JDH
—
05
—
890646H
—
NC
05
—
Q002555
—
TN
Enumeration date
09/09/2005
Last updated
02/11/2015
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