Provider Demographics
NPI:1962461293
Name:ROGERS, PAUL THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:THOMAS
Last Name:ROGERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2111 LAUREL BUSH RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6156
Mailing Address - Country:US
Mailing Address - Phone:410-569-3300
Mailing Address - Fax:410-515-2027
Practice Address - Street 1:2111 LAUREL BUSH RD
Practice Address - Street 2:SUITE H
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6156
Practice Address - Country:US
Practice Address - Phone:410-569-3300
Practice Address - Fax:410-515-2027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00227592080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities