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Individual

CHESTER LYNN ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
114 N WASHINGTON ST, BOURBON, IN 46504-1623
(574) 342-2444
(574) 342-2442
Mailing address
707 E CEDAR ST, STE 200, SOUTH BEND, IN 46617-2057
(574) 472-6700
(574) 472-6746

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041632
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000314564
ANTHEM
IN
01
000000803855
ANTHEM
IN
01
000000878019
ANTHEM
IN
01
000001417024
ANTHEM
IN
01
000001417982
ANTHEM
IN
01
000001418073
ANTHEM
IN
01
000001418134
ANTHEM
IN
01
000001418170
ANTHEM
IN
05
100328410
IN
Enumeration date
06/06/2006
Last updated
11/25/2020
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