Provider Demographics
NPI:1750362455
Name:ROE, DAVID MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:ROE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2415
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-2415
Mailing Address - Country:US
Mailing Address - Phone:410-749-4154
Mailing Address - Fax:410-860-9583
Practice Address - Street 1:1675 WOODBROOKE DRIVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-749-4154
Practice Address - Fax:410-860-9583
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2008-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD21598207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD22863OtherMDIPA OPTIMUM CHOICE
MD306491300Medicaid
DE0000187501Medicaid
221921800OtherUS DEPARTMENT OF LABOR
200022312OtherRAILROAD MEDICARE
66G45OtherEMPIRE BC BS
MDNP0022OtherFREESTATE DELMARVA HEALTH
327279OtherPRIME HEALTH
009W409OtherBCBS PROD FEP BLUE CHOICE
41996501H524PEOtherBCBS TRAD PRODUCTS
VA006477411Medicaid
3226876OtherAETNA
200022312OtherRAILROAD MEDICARE
221921800OtherUS DEPARTMENT OF LABOR