Provider Demographics
NPI:1760458129
Name:ROGERS, WILLIAM D (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:D
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ENTERPRISE DR
Mailing Address - Street 2:STE 100
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7894
Mailing Address - Country:US
Mailing Address - Phone:207-621-8700
Mailing Address - Fax:207-621-8701
Practice Address - Street 1:15 ENTERPRISE DR
Practice Address - Street 2:STE 100
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7894
Practice Address - Country:US
Practice Address - Phone:207-621-8700
Practice Address - Fax:207-621-8701
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012428207X00000X
MEMD12428207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME310850099Medicaid
MEMM2044Medicare ID - Type Unspecified
MENX2819Medicare PIN
MEMM204401Medicare PIN
MEB37975Medicare UPIN