Individual
DR. ROGER MENDES MARQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
12 PENNS TRAIL, SUITE 154, NEWTOWN, PA 18940-3438
(215) 675-3005
(888) 662-0859
Mailing address
888 WORCESTER ST, SUITE 130, WELLESLEY, MA 02482-3744
(617) 964-6681
(339) 686-2561
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC005633
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019062040005
—
PA
01
—
1354313
HIGHMARK BLUE SHIELD
PA
01
—
2046669000
KEYSTONE HEALTH PLAN EAST
PA
01
—
480033946
MEDICARE RAILROAD
PA
Enumeration date
07/01/2006
Last updated
10/12/2012
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