Provider Demographics
NPI:1689601577
Name:ROPER, CAROL K (MD)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:K
Last Name:ROPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2790 MOSSIDE BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146
Mailing Address - Country:US
Mailing Address - Phone:412-372-2277
Mailing Address - Fax:412-373-2307
Practice Address - Street 1:2790 MOSSIDE BLVD
Practice Address - Street 2:STE 105
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146
Practice Address - Country:US
Practice Address - Phone:412-372-2277
Practice Address - Fax:412-373-2307
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428268207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207N00000XAllopathic & Osteopathic PhysiciansDermatology
Not Answered207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I51715Medicare UPIN
PA100455TTSMedicare ID - Type Unspecified