Provider Demographics
NPI:1194715862
Name:PAUL D ROGERS MD PA
Entity type:Organization
Organization Name:PAUL D ROGERS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-982-0657
Mailing Address - Street 1:7309 HANOVER PKWY
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2032
Mailing Address - Country:US
Mailing Address - Phone:301-982-0657
Mailing Address - Fax:301-982-5325
Practice Address - Street 1:7309 HANOVER PKWY
Practice Address - Street 2:SUITE A&B
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-982-0657
Practice Address - Fax:301-982-5325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB93407Medicare UPIN
MDS22148Medicare UPIN
MDG00512Medicare PIN
MDE16604Medicare UPIN