Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | MD007626E | PA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD007626E | PA |
NPI | 1205082310 |
---|---|
Provider Name | Dr. Roger Lee Duerksen |
First Address | Pittsburgh, PA 15217-1045 |
Second Address | Pittsburgh, PA 15217-1045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2008 |
Last Update Date | 09/08/2008 |