Provider Demographics
NPI:1487002002
Name:ROQUE, CHARITA LEQUISSE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:CHARITA
Middle Name:LEQUISSE
Last Name:ROQUE
Suffix:
Gender:F
Credentials:MD, MPH
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Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-0336
Practice Address - Fax:410-550-0196
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2022-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD89575207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology