Healthcare Provider Details

I. General information

NPI: 1154343143
Provider Name (Legal Business Name): ROGER W. VOIGT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

PO BOX 64226
BALTIMORE MD
21264-4742
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6897
  • Fax: 410-328-2109
Mailing address:
  • Phone: 410-328-6897
  • Fax: 410-328-2109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberT38969
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: