Provider Demographics
NPI:1912065608
Name:MARCHANT, ROGER A (BSW,BA)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:A
Last Name:MARCHANT
Suffix:
Gender:M
Credentials:BSW,BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 6TH AVE W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34205-8820
Mailing Address - Country:US
Mailing Address - Phone:941-782-4267
Mailing Address - Fax:941-782-4113
Practice Address - Street 1:379 6TH AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34205-8820
Practice Address - Country:US
Practice Address - Phone:941-782-4267
Practice Address - Fax:941-782-4113
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator