Provider Demographics
NPI:1952375685
Name:ROGERS, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:ROGERS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1111 DELAFIELD ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3417
Mailing Address - Country:US
Mailing Address - Phone:262-544-8622
Mailing Address - Fax:262-544-8630
Practice Address - Street 1:1111 DELAFIELD ST
Practice Address - Street 2:SUITE 212
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3417
Practice Address - Country:US
Practice Address - Phone:262-544-8622
Practice Address - Fax:262-544-8630
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2014-08-12
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Provider Licenses
StateLicense IDTaxonomies
WI33316-020207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31816800Medicaid
WI100006592Medicare PIN
WI31816800Medicaid
WI000368085Medicare PIN