Provider Demographics
NPI:1962792366
Name:EDUARDO, ROGER FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:FRANCIS
Last Name:EDUARDO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3193 HOWELL MILL RD NW STE 125
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2100
Mailing Address - Country:US
Mailing Address - Phone:470-419-4380
Mailing Address - Fax:470-298-7732
Practice Address - Street 1:300 BULLSBORO DR STE B-C
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-1680
Practice Address - Country:US
Practice Address - Phone:770-683-3230
Practice Address - Fax:470-298-7732
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA83109208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017894500Medicaid