Provider Demographics
NPI:1093144818
Name:ROTERING, ROBERT H (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:H
Last Name:ROTERING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 159
Mailing Address - Street 2:810 N WELO STREET
Mailing Address - City:TIOGA
Mailing Address - State:ND
Mailing Address - Zip Code:58852-0159
Mailing Address - Country:US
Mailing Address - Phone:701-664-3305
Mailing Address - Fax:701-664-2240
Practice Address - Street 1:810 N WELO STREET
Practice Address - Street 2:
Practice Address - City:TIOGA
Practice Address - State:ND
Practice Address - Zip Code:58852-0159
Practice Address - Country:US
Practice Address - Phone:701-664-3305
Practice Address - Fax:701-664-2240
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND9333208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics