Individual
MR. ROGER CORDIAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
724 S HORNER BLVD, SANFORD, NC 27330-4822
(919) 776-6767
(919) 776-6773
Mailing address
724 S HORNER BLVD, SANFORD, NC 27330-4822
(919) 776-6767
(919) 776-6773
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
102171
NC
363AM0700X
Medical Physician Assistant
PA9102837
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34771
GROUP MEDICARE
FL
Enumeration date
10/21/2005
Last updated
04/05/2021
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