Individual
DR. ROGER WALCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 MAIN ST, SUITE 316, BUFFALO, NY 14214-2693
(716) 837-2400
(716) 837-3860
Mailing address
2121 MAIN ST, SUITE 316, BUFFALO, NY 14214-2693
(716) 837-2400
(716) 837-3860
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
254532-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03138965
—
NY
Enumeration date
05/22/2008
Last updated
02/23/2013
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