Basic Information
| Provider Information | |||||||||
| NPI: | 1497947949 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROATH | ||||||||
| FirstName: | MEREDITH | ||||||||
| MiddleName: | CORLEW | ||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CORLEW | ||||||||
| OtherFirstName: | MEREDITH | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 2324 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352012324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565337064 | ||||||||
| FaxNumber: | 2567040115 | ||||||||
| Practice Location | |||||||||
| Address1: | 119 LONGWOOD DR SW | ||||||||
| Address2: | |||||||||
| City: | HUNTSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 358014522 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2565336488 | ||||||||
| FaxNumber: | 2565336495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2007 | ||||||||
| LastUpdateDate: | 04/10/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | MD.28882 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.