Roller, Keith A
Roller, Keith A is an individual health care provider with primary practice located at 8401 Market St , Boardman OH 44512-6725. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Roller, Keith A can be contacted via phone (330) 286-5330.Contact Information
Primary practice address
8401 Market St
Boardman OH 44512-6725
Phone: (330) 286-5330
Fax: (330) 286-5396
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 35058177 | Ohio |
Profile Details
| NPI number | 1629012950 |
|---|---|
| LBN Legal business name | Roller, Keith A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | May 3rd, 2016 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629012950 | NPPES |
| Ohio | MEDICAID | 2600242 | |
| Ohio | Other | H011682 | |
| Ohio | Other | P01200681 | |
| Ohio | Other | 10896526 | |
| Ohio | MEDICAID | 1028247410001 | |
| Ohio | Other | 000000811586 |
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