Provider Demographics
NPI: | 1568998979 |
---|---|
Name: | RODGERS, ZACHARY BART (MD, PHD) |
Entity type: | Individual |
Prefix: | DR |
First Name: | ZACHARY |
Middle Name: | BART |
Last Name: | RODGERS |
Suffix: | |
Gender: | M |
Credentials: | MD, PHD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | PO BOX 829641 |
Mailing Address - Street 2: | |
Mailing Address - City: | PHILADELPHIA |
Mailing Address - State: | PA |
Mailing Address - Zip Code: | 19182-9641 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 673-705-2852 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 315 W STATE ST |
Practice Address - Street 2: | |
Practice Address - City: | DOYLESTOWN |
Practice Address - State: | PA |
Practice Address - Zip Code: | 18901-3525 |
Practice Address - Country: | US |
Practice Address - Phone: | 215-345-1900 |
Practice Address - Fax: | 215-345-4579 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2017-05-04 |
Last Update Date: | 2024-06-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
PA | MD467828 | 207RC0000X, 207RI0011X |
PA | 390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |