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Contact Information

RICHARD H ROETTGER, MD
12266 DE PAUL DR STE 305
BRIDGETON, MO63044
 Phone: 314-770-0991
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Trauma Surgery

2086S0127X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for RICHARD H ROETTGER · (Male)

NPI # 1932150638
Status Active
Credentials MD
Entity Individual
Enumeration date 05/15/2006
Last updated 10/26/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2014006605
  • SC License # 23291
  • SC Medicaid N01002
  • SC Other 4279822 AETNA ID
  • SC Other 576007863077 BCBS OF SC ID
  • SC Other 3087952 CIGNA ID
  • SC Other 020052517 RR MEDICARE
Hospital affiliation(s)
  • SSM DEPAUL HEALTH CENTER - (Acute Care)
    12303 DEPAUL DRIVE
    BRIDGETON, MO 63044
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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