Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 31986 | AL |
NPI | 1043206097 |
---|---|
Provider Name | David A Rogers |
First Address | Birmingham, AL 35294-3412 |
Second Address | Birmingham, AL 35294-3412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2005 |
Last Update Date | 24/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036102104 | (05) | IL |
E61382 | (02) |