Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 10773 | SC |
NPI | 1003893868 |
---|---|
Provider Name | Hudson C Rogers |
First Address | Charleston, SC 29406-9137 |
Second Address | Charleston, SC 29406-9137 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 18/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
107734 | (05) | SC |
D90807 | (02) | SC |