Provider Demographics
NPI:1942467170
Name:MENGEL, ROGER GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:GRANT
Last Name:MENGEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:625 CHERRY ST - ROOM 401
Mailing Address - Street 2:PA DEPT OF HEALTH - SOUTHEASTERN DISTRICT
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19602-1187
Mailing Address - Country:US
Mailing Address - Phone:610-378-4352
Mailing Address - Fax:610-621-5890
Practice Address - Street 1:625 CHERRY ST - ROOM 401
Practice Address - Street 2:PA DEPT OF HEALTH - SOUTHEASTERN DISTRICT
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19602-1187
Practice Address - Country:US
Practice Address - Phone:610-378-4352
Practice Address - Fax:610-621-5890
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PA15453E207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease