Roediger, John H

Roediger, John H is an individual health care provider with primary practice located at 1250 Forest Ave , Portland ME 04103-1897. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Roediger, John H can be contacted via phone (207) 797-5753.

Contact Information

Primary practice address
1250 Forest Ave Portland ME 04103-1897
Phone: (207) 797-5753
Fax: (207) 797-9571
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X MD8727 Maine

Profile Details

NPI number 1881682789
LBN Legal business name Roediger, John H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Apr 3rd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881682789 NPPES
Maine Other B86271 HARVARD PILGRIM
Maine MEDICAID 302230099 HARVARD PILGRIM
Maine Other 1044199 HARVARD PILGRIM
Maine Other 040512 HARVARD PILGRIM

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