Provider Demographics
NPI:1235572801
Name:ROACH-GERALD, CIERREA RASHONDA (MD)
Entity Type:Individual
Prefix:
First Name:CIERREA
Middle Name:RASHONDA
Last Name:ROACH-GERALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CIERREA
Other - Middle Name:RASHONDA
Other - Last Name:ROACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 S MAIN ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2937
Mailing Address - Country:US
Mailing Address - Phone:434-799-2111
Mailing Address - Fax:434-799-2297
Practice Address - Street 1:201 S MAIN ST STE 2100
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2937
Practice Address - Country:US
Practice Address - Phone:434-799-2111
Practice Address - Fax:434-799-2297
Is Sole Proprietor?:No
Enumeration Date:2013-04-12
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-00290208000000X
NE28332208000000X
VA0101269370208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics