Healthcare Provider Details

I. General information

NPI: 1851501159
Provider Name (Legal Business Name): JAMES MATTHEW ROGERS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 04/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24701 EUCLID AVE UNIVERSITY HOSPITAL MEDICAL GROUP, I
EUCLID OH
44117-1714
US

IV. Provider business mailing address

33092 N ROUNDHEAD DR
SOLON OH
44139-4825
US

V. Phone/Fax

Practice location:
  • Phone: 216-383-6614
  • Fax:
Mailing address:
  • Phone: 440-343-1451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: