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Individual

MS. ANGELA YOUNG ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 855-3406
Mailing address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
(540) 855-3406

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-02143
NC
363A00000X
Physician Assistant
Primary
0110-004595
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8102881
NC
Enumeration date
04/12/2010
Last updated
07/08/2015
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