Provider Demographics
NPI:1972686509
Name:FILAMOR, ROGER A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROGER
Middle Name:A
Last Name:FILAMOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROGELIO
Other - Middle Name:A
Other - Last Name:FILAMOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9110 PHILADELPHIA ROAD
Mailing Address - Street 2:SUITE NO 210
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4325
Mailing Address - Country:US
Mailing Address - Phone:410-391-3003
Mailing Address - Fax:410-391-7011
Practice Address - Street 1:9110 PHILADELPHIA ROAD
Practice Address - Street 2:SUITE NO 210
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4325
Practice Address - Country:US
Practice Address - Phone:410-391-3003
Practice Address - Fax:410-391-7011
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD16238208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
3210Medicare ID - Type Unspecified
D70366Medicare UPIN