Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 000045346 | AL |
NPI | 1013974484 |
---|---|
Provider Name | Richard Alvin Roh |
First Address | Mobile, AL 36689-0159 |
Second Address | Fairhope, AL 36532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 14/07/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000045346 | (05) | AL |
C74981 | (02) |