Individual
ROGER MARTIN VEGA BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(404) 367-3014
Mailing address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(678) 604-5901
(678) 604-5910
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
77322
GA
207R00000X
Internal Medicine Physician
ME151274
FL
208M00000X
Hospitalist Physician
77322
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/25/2013
Last updated
02/26/2025
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