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General NPI Number Information
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NPI Number | 1083928170
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Entity Type | Organization
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Legal Business Name | ROGER N DANZIGER MD PA
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 5404 CORTEZ RD W
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City | BRADENTON
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State | FL
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Zip | 34210-2815
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Country | US
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Telephone | 941-761-1911
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Fax | 941-761-9223
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Provider Business Mailing Address
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Address Line | PO BOX 14908
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City | BRADENTON
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State | FL
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Zip | 34280-4908
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Country | US
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Telephone | 941-761-1911
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Fax | 941-761-9223
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Authorized Official
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Title or Position | DOCTOR/PRESIDENT
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Name | DR. ROGER NOLAND DANZIGER
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Credential | MD
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Telephone | 941-761-1911
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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 | ME58560
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License Number State | FL
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