Provider Demographics
NPI:1043358971
Name:BECKWITH, ROSHELLE J (MD)
Entity Type:Individual
Prefix:
First Name:ROSHELLE
Middle Name:J
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:952 EDWARDS FERRY RD NE
Mailing Address - Street 2:METROMED URGENT CARE
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-3324
Mailing Address - Country:US
Mailing Address - Phone:703-687-4158
Mailing Address - Fax:703-687-4159
Practice Address - Street 1:952 EDWARDS FERRY RD NE
Practice Address - Street 2:METROMED URGENT CARE
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-3324
Practice Address - Country:US
Practice Address - Phone:703-687-4158
Practice Address - Fax:703-687-4159
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0067483207P00000X
MD207742-0207P00000X
NY272739-1207P00000X
PAMD450056207P00000X
OH35.128085207P00000X
VA0101257398207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.128085OtherSTATE LISENCE