Individual
DAVID PAUL RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 MAIN ST, BONNEAU, SC 29431-5013
(843) 825-3404
(843) 825-3407
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11879
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080096524
RR MEDICARE
SC
05
—
118795
—
SC
Enumeration date
04/27/2006
Last updated
06/10/2021
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