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Roger Fabian Anderson Jr., MD

in Raleigh, NC. Individual provider (NPI-1).

NPI number1528096591
StatusActive
Last updated in NPPESMar 30, 2021

Details

NPI
1528096591
Entity type
Individual (NPI-1)
Name
Roger Fabian Anderson Jr.
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jun 29, 2006
Certification date
Mar 30, 2021
Last updated
Mar 30, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2085R0001X 39233NCYes
2085R0001X 30738SC

Practice location

11200 Governor Manly Way
Suite 102
Raleigh, NC 27614-8595

Phone 919-570-7550 · Fax 919-570-7551

Mailing address

11200 Governor Manly Way
Suite 102
Raleigh, NC 27614-8595

Phone 919-570-7550 · Fax 919-570-7551

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