Provider Demographics
NPI:1891987681
Name:ROGER RAIFORD & PATRICK NOEL PTR
Entity Type:Organization
Organization Name:ROGER RAIFORD & PATRICK NOEL PTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-345-0377
Mailing Address - Street 1:7251 HANOVER PARKWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770
Mailing Address - Country:US
Mailing Address - Phone:301-345-0377
Mailing Address - Fax:301-345-1799
Practice Address - Street 1:7251 HANOVER PARKWAY
Practice Address - Street 2:SUITE B
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-345-0377
Practice Address - Fax:301-345-1799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDN6489OtherRAILROAD MEDICARE-GROUP PTAN
MDDN6489OtherRAILROAD MEDICARE-GROUP PTAN