Provider Demographics
NPI:1518079615
Name:ROGERS, JAMES D (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2620 GENESYS PKWY
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7326
Mailing Address - Country:US
Mailing Address - Phone:810-606-6444
Mailing Address - Fax:810-606-6235
Practice Address - Street 1:2620 GENESYS PKWY
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-7326
Practice Address - Country:US
Practice Address - Phone:810-606-6444
Practice Address - Fax:810-606-6235
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301035147208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4590120Medicaid
MIA11651Medicare UPIN
MA4590120Medicaid