Provider Demographics
NPI:1548434863
Name:ROTH, PRERANA JAIN (MD)
Entity type:Individual
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First Name:PRERANA
Middle Name:JAIN
Last Name:ROTH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-797-6044
Mailing Address - Fax:864-797-6198
Practice Address - Street 1:890 W FARIS RD
Practice Address - Street 2:SUITE 520
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4253
Practice Address - Country:US
Practice Address - Phone:864-455-9033
Practice Address - Fax:864-455-6559
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2014-03-10
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Provider Licenses
StateLicense IDTaxonomies
SC36564207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease