Individual
GRETCHEN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10000 W BLUEMOUND RD, WAUWATOSA, WI 53226-4321
(414) 454-4321
(414) 805-3808
Mailing address
10000 W BLUEMOUND RD, WAUWATOSA, WI 53226-4321
(414) 454-4321
(414) 805-3808
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
69129
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912311614
—
WI
Enumeration date
06/20/2014
Last updated
07/26/2022
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