| Tova Rogers Md Mfa Pllc | |
|
1404 Bridge St Charlevoix MI 49720-2603 | |
| (231) 497-1272 | |
| (248) 780-6936 |
| Full Name | Tova Rogers Md Mfa Pllc |
|---|---|
| Speciality | Dermatology |
| Location | 1404 Bridge St, Charlevoix, Michigan |
| Authorized Official Name and Position | Tova Rogers (OWNER) |
| Authorized Official Contact | 2488940196 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tova Rogers Md Mfa Pllc 1404 Bridge St Charlevoix MI 49720-2603 Ph: (248) 894-0196 | Tova Rogers Md Mfa Pllc 1404 Bridge St Charlevoix MI 49720-2603 Ph: (231) 497-1272 |
| NPI Number | 1336865112 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 01/04/2023 |
| Medicare PECOS PAC ID | 4486024569 |
|---|---|
| Medicare Enrollment ID | O20230105003118 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336865112 | NPI | - | NPPES |
| 4301504820 | Other | MI | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
| Provider Name | Tova Rogers |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1356872246 PECOS PAC ID: 3173873718 Enrollment ID: I20210616000291 |
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