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General NPI Number Information
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NPI Number | 1639172562
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Entity Type | Individual
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Provider Name | ROGER M. WINT M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 09/07/2007
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Provider Practice Location Address
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Address Line | 9501 ROOSEVELT BLVD STE 501
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1030
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Country | US
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Telephone | 215-673-5000
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Fax | 215-673-0718
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Provider Business Mailing Address
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Address Line | 9501 ROOSEVELT BLVD STE 305
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1028
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Country | US
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Telephone | 215-671-4280
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Fax | 215-464-9034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD024876E
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License Number State | PA
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