Provider Demographics
NPI:1992774749
Name:WESTFALL, ROGER K (MD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:K
Last Name:WESTFALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:140 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:FRONT ROYAL
Mailing Address - State:VA
Mailing Address - Zip Code:22630-3512
Mailing Address - Country:US
Mailing Address - Phone:540-631-3700
Mailing Address - Fax:540-635-1673
Practice Address - Street 1:351 VALLEY HEALTH WAY STE 300
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-6480
Practice Address - Country:US
Practice Address - Phone:540-631-3700
Practice Address - Fax:540-635-1673
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032011207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005687969Medicaid
VA018062OtherANTHEM
VA080032088OtherRAILROAD MEDICARE
VAB09738Medicare UPIN
VA005687969Medicaid