Individual
ROGER K. WAAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 723-0015
Mailing address
330 N 8TH AVE E, DULUTH, MN 55805-2024
(218) 723-1112
(218) 723-0015
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23375
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-15943
MEDICA
—
05
—
30226800
—
WI
01
—
8T142WA
BCBSMN
MN
01
—
C005
TRICARE WEST
—
01
—
CN1040796006
PREFERREDONE
—
01
—
HP22430
HEALTHPARTNERS
—
Enumeration date
10/19/2005
Last updated
07/08/2007
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