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NPI Code Detail

MEDICARE: DR. ROGER WAYNE BOATWRIGHT M.D.

MEDICARE: DR. ROGER WAYNE BOATWRIGHT M.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
1207V00000XObstetrics & Gynecology Physician0101242423VA
2207V00000XObstetrics & Gynecology PhysicianMD440992PA
3208D00000XGeneral Practice PhysicianMD440992PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366656712
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROGER WAYNE BOATWRIGHT M.D.
Provider Business Mailing Address
First Line : 157 BALTIMORE ST STE 104
Second Line :
City : CUMBERLAND
State : MD
Zip : 21502-2472
Country : US
Telephone Number : 301-722-0484
Fax Number : 833-903-0130
Provider Business Practice Location Address
First Line : 100 ABBEYVILLE RD
Second Line :
City : LANCASTER
State : PA
Zip : 17603-4604
Country : US
Telephone Number : 301-722-0484
Fax Number : 833-903-0130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 11/04/2025

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