Provider Demographics
NPI:1285626226
Name:ROGERS, CHRISTOPHER BRIAN (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 KEISER BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3338
Mailing Address - Country:US
Mailing Address - Phone:610-685-8500
Mailing Address - Fax:610-685-4833
Practice Address - Street 1:2605 KEISER BOULEVARD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3338
Practice Address - Country:US
Practice Address - Phone:610-685-8500
Practice Address - Fax:610-685-4833
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS012595207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1022998480001Medicaid
I44694Medicare UPIN
095615FJEMedicare PIN