Individual
LARRY CALVIN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7 MEMORIAL DRIVE, PETERSBURG, WV 26847-0007
(304) 257-4511
(304) 257-4511
Mailing address
PO BOX 7, PETERSBURG, WV 26847-0007
(304) 257-4511
(304) 257-4511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10484
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055759000
—
WV
Enumeration date
10/25/2006
Last updated
07/08/2007
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