Provider Demographics
NPI:1831100593
Name:ROGERS, MICHAEL HENRY (DC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:HENRY
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SCHOOSETT ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-1822
Mailing Address - Country:US
Mailing Address - Phone:781-826-6311
Mailing Address - Fax:781-826-6634
Practice Address - Street 1:212 SCHOOSETT ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:MA
Practice Address - Zip Code:02359-1822
Practice Address - Country:US
Practice Address - Phone:781-826-6311
Practice Address - Fax:781-826-6634
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1602551Medicaid
T79808Medicare UPIN
Y35419Medicare ID - Type Unspecified