Provider Demographics
NPI:1487649208
Name:BAYOG, ROGELIO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGELIO
Middle Name:
Last Name:BAYOG
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:PO BOX 260
Mailing Address - Street 2:MOAK ASSOCIATES
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-0260
Mailing Address - Country:US
Mailing Address - Phone:508-898-8650
Mailing Address - Fax:508-870-9397
Practice Address - Street 1:88 WASHINGTON ST
Practice Address - Street 2:MORTON HOSPITAL
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2465
Practice Address - Country:US
Practice Address - Phone:508-282-7443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-19
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA408182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3188205Medicaid
MAJ03195OtherBC/BS OF MASSACHUSETTS
MA799542OtherTUFTS MEDICARE PREFERRED
MAJ03195OtherFEDERAL BC/BS
MA799542OtherTUFTS
MAJ03195OtherBLUE CARD
MAJ03195Medicare PIN
MA799542OtherTUFTS MEDICARE PREFERRED
MAP00092333Medicare PIN