Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | N9771 | TX |
N | 208200000X | Surgeon | N9771 | TX |
N | 208600000X | Surgeon | N9771 | TX |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 0101258480 | VA |
NPI | 1114127123 |
---|---|
Provider Name | Mark E. Roeser |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2007 |
Last Update Date | 16/07/2015 |