MEDICARE: MR. JAMES MATTHEW ROGERS PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1851501159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES MATTHEW ROGERS PA-C

Provider Business Mailing Address
First Line	:	33092 N ROUNDHEAD DR
Second Line	:
City	:	SOLON
State	:	OH
Zip	:	44139-4825
Country	:	US
Telephone Number	:	440-343-1451
Fax Number	:

Provider Business Practice Location Address
First Line	:	24701 EUCLID AVE
Second Line	:	UNIVERSITY HOSPITAL MEDICAL GROUP, I
City	:	EUCLID
State	:	OH
Zip	:	44117-1714
Country	:	US
Telephone Number	:	216-383-6614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2007
Last Update Date	:	04/29/2015

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