Doctor Name: | DR. ROGER J. OLDHAM |
NPI Number: | 1861488611 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 10215 Fernwood Rd Suite 412 Bethesda, MD - 208171106 |
Business Phone Number: | 3015306100 |
Business Fax Number: | 3015306104 |
Mailing Address: | 10215 Fernwood Rd, Suite 412 BETHESDA |
State: | MD |
Postal Code: | 208171106 |
Phone Number: | 3015306100 |
Fax Number: | 3015306104 |
NPI Enumeration Date: | 09/26/2005 |
NPI Last Update Date: | 03/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/24/2006 |
NPI Reactivation Date: | 04/28/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |