Healthcare Provider Details

I. General information

NPI: 1487649208
Provider Name (Legal Business Name): ROGELIO BAYOG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 WASHINGTON ST MORTON HOSPITAL
TAUNTON MA
02780-2465
US

IV. Provider business mailing address

PO BOX 260 MOAK ASSOCIATES
WESTBOROUGH MA
01581-0260
US

V. Phone/Fax

Practice location:
  • Phone: 508-282-7443
  • Fax:
Mailing address:
  • Phone: 508-898-8650
  • Fax: 508-870-9397

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number40818
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: