Individual
CARL B ROUNTREE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5875 BREMO RD, SUITE 303, RICHMOND, VA 23226-1934
(804) 893-8610
(804) 287-7285
Mailing address
5875 BREMO RD, SUITE 303, RICHMOND, VA 23226-1934
(804) 893-8610
(804) 287-7285
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
0101251638
VA
2080P0206X
Pediatric Gastroenterology Physician
MD431447
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C06778
GROUP PTAN
VA
01
—
MD431447
MEDICAL LICENSE
PA
Enumeration date
06/11/2007
Last updated
06/12/2012
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