Provider Demographics
NPI:1346480332
Name:CARLA J. ROTERING, MD, PLC
Entity Type:Organization
Organization Name:CARLA J. ROTERING, MD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ROTERING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-908-1315
Mailing Address - Street 1:1401 W BECK LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-4457
Mailing Address - Country:US
Mailing Address - Phone:602-908-1315
Mailing Address - Fax:
Practice Address - Street 1:1401 W BECK LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-4457
Practice Address - Country:US
Practice Address - Phone:602-908-1315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ15679207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty