Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | OS012595 | PA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | OS012595 | PA |
NPI | 1285626226 |
---|---|
Provider Name | Christopher Brian Rogers |
First Address | Wyomissing, PA 19610-3338 |
Second Address | Wyomissing, PA 19610-3338 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 22/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1022998480001 | (05) | PA |
I44694 | (02) |