Provider Demographics
NPI:1740514280
Name:ROTH, STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:ROTH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:310 EISENHOWER DR
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2632
Mailing Address - Country:US
Mailing Address - Phone:912-692-1451
Mailing Address - Fax:912-352-3980
Practice Address - Street 1:310 EISENHOWER DR
Practice Address - Street 2:SUITE 5
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-692-1451
Practice Address - Fax:912-352-3980
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAO43759207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease