Provider Demographics
NPI:1124581921
Name:ROGERS, CAVIER CHARLES JR
Entity Type:Individual
Prefix:
First Name:CAVIER
Middle Name:CHARLES
Last Name:ROGERS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22760 CIVIC CENTER DR APT A1
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-7150
Mailing Address - Country:US
Mailing Address - Phone:313-999-1399
Mailing Address - Fax:
Practice Address - Street 1:22760 CIVIC CENTER DR APT A1
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-7150
Practice Address - Country:US
Practice Address - Phone:313-999-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-09
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care