MEDICARE: BENJAMIN ROGERS 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	207Q00000X	Family Medicine Physician	LL95055	SC

General Provider Information

NPI Number	:	1922837285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN ROGERS MD

Provider Business Mailing Address
First Line	:	135 CANNON ST STE 405
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 CANNON ST STE 405
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-2610
Country	:	US
Telephone Number	:	843-876-7080
Fax Number	:

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

Provider Enumeration Date	:	07/26/2024
Last Update Date	:	07/01/2025

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