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Individual

ERIC BRANDON ROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1575 BEAM AVE, EMERGENCY DEPT, MAPLEWOOD, MN 55109-1126
(651) 232-7000
Mailing address
20744 GEMINI TRL, LAKEVILLE, MN 55044-2515
(952) 985-7099

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
21199
MN
207P00000X
Emergency Medicine Physician
Primary
53834
MN

Other

Enumeration date
07/22/2008
Last updated
02/04/2022
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