Provider Demographics
NPI:1578671475
Name:ROGAN, JOHN E (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:E
Last Name:ROGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:520 SAYBROOK ROAD
Mailing Address - Street 2:MIDDLESEX CARDIOLOGY ASSOCIATES
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457
Mailing Address - Country:US
Mailing Address - Phone:860-347-4258
Mailing Address - Fax:860-704-5924
Practice Address - Street 1:520 SAYBROOK ROAD
Practice Address - Street 2:MIDDLESEX CARDIOLOGY ASSOCIATES
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457
Practice Address - Country:US
Practice Address - Phone:860-347-4258
Practice Address - Fax:860-704-5924
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT022950207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
010022950CT01OtherANTHEM
0000215318001OtherUNITED HC
052391OtherCT
P1263058OtherOXFORD
2106279OtherAETNA
00122950900OtherEDS BLUE CARE
OV0691OtherHEALTH NET
0086737003OtherCIGNA
00122950900OtherEDS BLUE CARE