Provider Demographics
NPI:1407147986
Name:ROGERS, STAR (MD)
Entity Type:Individual
Prefix:
First Name:STAR
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 PHIPPS BLVD NE APT 2512
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-3374
Mailing Address - Country:US
Mailing Address - Phone:404-205-1889
Mailing Address - Fax:404-592-5505
Practice Address - Street 1:600 PHIPPS BLVD NE APT 2512
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-3374
Practice Address - Country:US
Practice Address - Phone:404-205-1889
Practice Address - Fax:404-592-5505
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73636207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology