Individual
ROGER DURAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0278421
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1217227
MEDICA
—
01
—
48048DU
BLUE CROSS BLUE SHIELD
MN
01
—
CP9020830012
PREFERRED ONE
—
Enumeration date
07/28/2006
Last updated
07/08/2007
Update your record
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