Individual
MR. ROGER MCKNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18 DENTON PLZ, DENTON, MD 21629-9501
(667) 292-0335
Mailing address
18 DENTON PLZ, DENTON, MD 21629-9501
(667) 292-0335
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
PR0563
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PR0563
STATE CERTIFICATION
MD
Enumeration date
08/30/2023
Last updated
08/30/2023
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