Healthcare Provider Details

I. General information

NPI: 1073508149
Provider Name (Legal Business Name): RODGER D ISRAEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3237 BLUE RIDGE RD
RALEIGH NC
27612-8036
US

IV. Provider business mailing address

3237 BLUE RIDGE RD STE 300
RALEIGH NC
27612-8010
US

V. Phone/Fax

Practice location:
  • Phone: 919-781-7500
  • Fax: 919-645-3054
Mailing address:
  • Phone: 919-781-7500
  • Fax: 919-645-3054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number31539
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number31539
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: