Provider Demographics
NPI:1629002381
Name:ROGERS, IAN S (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:S
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DRIVE, H2157
Mailing Address - Street 2:STANFORD UNIVERSITY, CARDIOVASCULAR MEDICINE
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5233
Mailing Address - Country:US
Mailing Address - Phone:650-723-4000
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DRIVE, H2157
Practice Address - Street 2:STANFORD UNIVERSITY, CARDIOVASCULAR MEDICINE
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5233
Practice Address - Country:US
Practice Address - Phone:650-723-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107147207RC0000X, 207RA0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0002XAllopathic & Osteopathic PhysiciansInternal MedicineAdult Congenital Heart Disease
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease