Provider Demographics
NPI:1609890615
Name:ROGERS, ERIN PHILLIPS (PA)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:PHILLIPS
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:WHITNEY
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:9228 MEDICAL PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9125
Mailing Address - Country:US
Mailing Address - Phone:843-574-5693
Mailing Address - Fax:843-764-4512
Practice Address - Street 1:1 DOCTORS DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4266
Practice Address - Country:US
Practice Address - Phone:843-574-5693
Practice Address - Fax:843-764-4512
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1703363A00000X, 207R00000X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC232009OtherMEDICARE
SC1272PAMedicaid
SCAA78639223Medicare PIN
NC232009OtherMEDICARE