Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 200501493 | NC |
Y | 208200000X | Surgeon | 200501493 | NC |
Y | 208600000X | Surgeon | 200501493 | NC |
NPI | 1073598140 |
---|---|
Provider Name | Jeffrey Rogers |
First Address | Winston Salem, NC 27157-0001 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2005 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10208343 | (05) | VA |
1402J | BCBS (01) | |
184303 | MEDCOST (01) | |
3810003469 | (05) | WV |
5902246 | (05) | NC |
7056011 | AETNA (01) | |
806732 | PARTNERS (01) | |
G93659 | (02) | |
P00300023 | RR MEDICARE (01) | |
T53331 | (05) | SC |