Provider Demographics
NPI:1275783292
Name:ROGERS, WILLIAM HERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HERMAN
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ARUNDEL RD
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1206
Mailing Address - Country:US
Mailing Address - Phone:410-263-6469
Mailing Address - Fax:
Practice Address - Street 1:38 ARUNDEL RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1206
Practice Address - Country:US
Practice Address - Phone:410-263-6469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00282832086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD74416Medicare UPIN
MD148821ZC9BMedicare PIN