Provider Demographics
NPI:1710338629
Name:ROIG, JOSE ANDRES (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ANDRES
Last Name:ROIG
Suffix:
Gender:M
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:UNIVERSITY OF NEVADA, RENO SCHOOL OF MEDICINE
Mailing Address - Street 2:1155 MILL ST. W11
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-327-5174
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF NEVADA, RENO SCHOOL OF MEDICINE
Practice Address - Street 2:1155 MILL ST. W11
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-327-5174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-22
Last Update Date:2018-04-11
Deactivation Date:2018-03-29
Deactivation Code:
Reactivation Date:2018-04-11
Provider Licenses
StateLicense IDTaxonomies
IN11019013A390200000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program