ROGER L DESHONG PA

LIFEBRIDGE COMMUNITY PHYSICIANS INC

Dr ROGER L DESHONG PA is a male medical professional, specializing in Physician Assistant. He graduated in 2002.

Contact

LIFEBRIDGE COMMUNITY PHYSICIANS INC

5401 OLD COURT RD
RANDALLSTOWN
MD
211335103

Tel:

ROGER L DESHONG PA Information

Npi 1164483335
Pac Id 4981629581
Professional Enrollment Id I20051012001184
Last Name DESHONG
First Name ROGER
Middle Name L
Suffix
Gender M
Credential PA
Medical School Name OTHER
Graduation Year 2002
Primary Specialty PHYSICIAN ASSISTANT
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name LIFEBRIDGE COMMUNITY PHYSICIANS INC
Group Practice Pac Id 3678751468
Number Of Group Practice Members 111
Line 1 Street Address 5401 OLD COURT RD
Line 2 Street Address
Marker Of Address Line 2 Suppression
City RANDALLSTOWN
State MD
Zip Code 211335103
Phone Number
Hospital Affiliation Ccn 1 210040
Hospital Affiliation Lbn 1 NORTHWEST HOSPITAL CENTER
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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