Healthcare Provider Details

I. General information

NPI: 1619243789
Provider Name (Legal Business Name): ANTHONY RICHARD ROGGIO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2012
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 S PACA STREET 6TH FLOOR, SUITE 200
BALTIMORE MD
21201
US

IV. Provider business mailing address

250 W PRATT ST STE 790
BALTIMORE MD
21201-2470
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-8667
  • Fax:
Mailing address:
  • Phone: 410-328-8040
  • Fax: 410-328-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0080054
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0080054
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberD0080054
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: