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Individual

TATE M ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
961 E STUART DR, GALAX, VA 24333-2407
(276) 236-9953
(276) 236-6084
Mailing address
961 E STUART DR, GALAX, VA 24333-2407
(276) 236-9953
(276) 236-6084

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101030999
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2007211081
VA
01
C05711
MEDICARE GROUP #
Enumeration date
07/13/2007
Last updated
02/12/2008
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