Provider Demographics
NPI:1164411609
Name:KARTAN, ROOPA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROOPA
Middle Name:
Last Name:KARTAN
Suffix:
Gender:F
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:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10190 US HIGHWAY 42
Practice Address - Street 2:STE 210D
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9525
Practice Address - Country:US
Practice Address - Phone:937-644-1920
Practice Address - Fax:937-644-2024
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058790L208000000X
OH35.068161208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01575783Medicaid
PAMD058790LOtherMEDICAL LIC NUMBER
PAMD058790LOtherMEDICAL LIC NUMBER
PAMD058790LOtherMEDICAL LIC NUMBER
PA01575783Medicaid