Provider Demographics
NPI:1992749568
Name:ROGERS, HEATHER A (MD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:A
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:1120 SEVEN LAKES DRIVE
Mailing Address - City:WEST END
Mailing Address - State:NC
Mailing Address - Zip Code:27376-0009
Mailing Address - Country:US
Mailing Address - Phone:910-673-9111
Mailing Address - Fax:910-673-6202
Practice Address - Street 1:227 N MAIN ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NC
Practice Address - Zip Code:27371-3015
Practice Address - Country:US
Practice Address - Phone:910-572-3681
Practice Address - Fax:910-572-5579
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901568Medicaid
NC5901568Medicaid