Individual
ROGER G AMIGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2160 EWING CRAWFIS CIR, BELLEFONTAINE, OH 43311-9042
(937) 593-0070
(937) 599-0075
Mailing address
2160 EWING CRAWFIS CIR, BELLEFONTAINE, OH 43311-9042
(937) 593-0070
(937) 599-0075
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
5016
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007681
ANTHAN BCBS
OH
05
—
0836760
—
OH
01
—
310884319033
CARESOURCE
OH
01
—
340010844
RAILROAD MEDICARE PALMETT
OH
01
—
3980672
CIGNA
OH
01
—
5198086
AETNA
OH
Enumeration date
07/15/2005
Last updated
11/18/2016
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