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General NPI Number Information
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NPI Number | 1063541647
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Entity Type | Organization
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Legal Business Name | GERALD D. ROGELL, M.D., P.A.
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 04/25/2011
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Provider Practice Location Address
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Address Line | 11119 ROCKVILLE PIKE SUITE #404
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City | ROCKVILLE
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State | MD
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Zip | 20852-3143
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Country | US
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Telephone | 301-468-1381
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Fax | 301-816-1079
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Provider Business Mailing Address
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Address Line | 11119 ROCKVILLE PIKE SUITE #404
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City | ROCKVILLE
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State | MD
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Zip | 20852-3143
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Country | US
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Telephone | 301-468-1381
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Fax | 301-816-1079
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GERALD DAVID ROGELL
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Credential | M.D.
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Telephone | 301-468-1381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0015051
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License Number State | MD
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