Individual
CHARLES P ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6845 E US HIGHWAY 36, AVON, IN 46123-8132
(317) 272-4920
(317) 272-4906
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01053902A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000373278
ANTHEM
IN
05
—
200523230
—
IN
Enumeration date
01/20/2006
Last updated
12/30/2020
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