MEDICARE: DAVID R ROGERSON MD

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
1	207YX0602X	Otolaryngic Allergy Physician	MD016845E	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1902816630
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID R ROGERSON MD

Provider Business Mailing Address
First Line	:	348 BUDFIELD STREET
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-3214
Country	:	US
Telephone Number	:	814-262-3950
Fax Number	:	814-262-3990

Provider Business Practice Location Address
First Line	:	348 BUDFIELD STREET
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15904-3214
Country	:	US
Telephone Number	:	814-262-3950
Fax Number	:	814-262-3990

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	12/01/2009

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