Healthcare Provider Details

I. General information

NPI: 1902070790
Provider Name (Legal Business Name): STEVEN CRAIG ROGERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 09/22/2022
Certification Date: 09/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST CONNECTICUT CHILDRENS MEDICAL CENTER
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST CONNECTICUT CHILDRENS MEDICAL CENTER
HARTFORD CT
06106-3322
US

V. Phone/Fax

Practice location:
  • Phone: 860-560-3640
  • Fax:
Mailing address:
  • Phone: 860-560-3640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number046460
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: