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NPI Code Detail

MEDICARE: DR. THOMAS EDWARD RODGERSON PH.D.

MEDICARE: DR. THOMAS EDWARD RODGERSON PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLC0154MD

General Provider Information

NPI Number : 1346248580
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS EDWARD RODGERSON PH.D.
Provider Business Mailing Address
First Line : 14616 JAYSTONE DR
Second Line :
City : SILVER SPRING
State : MD
Zip : 20905-7405
Country : US
Telephone Number : 301-388-2535
Fax Number : 301-388-2536
Provider Business Practice Location Address
First Line : 8203 HARFORD RD
Second Line :
City : PARKVILLE
State : MD
Zip : 21234-5888
Country : US
Telephone Number : 410-882-1988
Fax Number : 410-882-1898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 07/08/2007

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