| Rudolf Roth, MD | |
|
250 King Of Prussia Rd, Radnor, PA 19087 | |
| (610) 902-2000 | |
| Not Available |
| Full Name | Rudolf Roth |
|---|---|
| Gender | Male |
| Speciality | Dermatology |
| Location | 250 King Of Prussia Rd, Radnor, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386683886 | NPI | - | NPPES |
| 0018542420003 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | MD073956L (Pennsylvania) | Primary |
| Entity Name | University Of Penn - Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235527342 PECOS PAC ID: 6204730955 Enrollment ID: O20141111000091 |
| Mailing Address | Practice Location Address |
|---|---|
| Rudolf Roth, MD 250 King Of Prussia Rd, Radnor, PA 19087 Ph: (610) 902-2400 | Rudolf Roth, MD 250 King Of Prussia Rd, Radnor, PA 19087 Ph: (610) 902-2000 |
Meera Sivendran, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 145 King Of Prussia Road, Suite 306 South, Radnor, PA 19087 Phone: 610-902-2400 Fax: 610-902-2404 | |
Cherie M Ditre, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 250 King Of Prussia Rd, Radnor, PA 19087 Phone: 610-902-2428 Fax: 610-902-2404 | |
Dr. Catherine M Quirk, MD Dermatology Medicare: Medicare Enrolled Practice Location: 250 King Of Prussia Road, Radnor, PA 19087 Phone: 610-902-2000 |