Ted M. Roth
Obstetrician & Gynecologist Female Pelvic Medicine and Reconstructive Surgeon
621 Memorial Dr Ste 302
South Bend
, Indiana 46601-1073
Ted M. Roth
Obstetrician & Gynecologist Female Pelvic Medicine and Reconstructive Surgeon
621 Memorial Dr Ste 302
South Bend
, Indiana 46601-1073
(574) 237-6069
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About
Features
Specialties
- Obstetrician & Gynecologist
- Female Pelvic Medicine and Reconstructive Surgeon
Languages spoken
- English
Location
First Address
- Ted M. Roth
- 710 N Niles Ave
- South Bend, IN
- Zip : 46617-1924
- Fax : (574) 237-6069
- Phone : (574) 647-1610
Second Address
- Ted M. Roth
- 621 Memorial Dr Ste 302
- South Bend, IN
- Zip : 46601-1073
- Fax : (574) 367-3801
- Phone : (574) 367-3800
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207V00000X | Obstetrician & Gynecologist | 01081226A | IN |
| Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 01081226A | IN |
National Provider Identifier
| NPI | 1174503866 |
|---|---|
| Provider Name | Ted M. Roth |
| First Address | South Bend, IN 46617-1924 |
| Second Address | South Bend, IN 46601-1073 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/01/2006 |
| Last Update Date | 05/04/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 300020434 | (05) | IN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.