Provider Demographics
NPI:1538119920
Name:ROGERS, RACHEL MARIE (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
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 1:1204 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4312
Mailing Address - Country:US
Mailing Address - Phone:276-783-2511
Mailing Address - Fax:276-783-2532
Practice Address - Street 1:1204 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4312
Practice Address - Country:US
Practice Address - Phone:276-783-2511
Practice Address - Fax:276-783-2532
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101231927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006737587Medicaid
VATN0101OtherJOHN DEERE PROVIDER NO.
VA321775OtherSOUTHERN HEALTH PROVIDER
VA461268OtherANTHEM BC PROVIDER NUMBER
VAH28393Medicare UPIN