Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 35.131702 | OH |
N | 111NI0900X | Internist | 35.131702 | OH |
N | 207R00000X | Internist | LP03237 | RI |
N | 111NI0900X | Internist | LP03237 | RI |
Y | 207RH0000X | Hematologist | MD23603 | ME |
NPI | 1225441017 |
---|---|
Provider Name | Dr. Andrew Mark Rogers |
First Address | South Portland, ME 04106-2458 |
Second Address | South Portland, ME 04106-2458 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2014 |
Last Update Date | 19/07/2020 |