Individual
ROGER G ROOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4100
(208) 381-1665
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-4100
(208) 381-1665
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M6840
ID
Other
Enumeration date
10/16/2006
Last updated
11/16/2011
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