Individual
DR. GARY ARTHUR ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
404 E CENTER AVE, MOORESVILLE, NC 28115-2544
(704) 663-3924
(704) 663-7057
Mailing address
404 E CENTER AVE, MOORESVILLE, NC 28115-2544
(704) 663-3924
(704) 663-7057
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
863
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0236390001
PALMETTO DMERC
NC
01
—
09775
BCBS
NC
01
—
15906
PARTNERS
NC
01
—
2209268
UNITED HEALTHCARE
NC
05
—
8909775
—
NC
Enumeration date
07/19/2005
Last updated
11/20/2014
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