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NPI Code Detail

MEDICARE: DR. THOMAS M ROESCH MD

MEDICARE:  DR. THOMAS M ROESCH  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist14872SC
2207V00000XObstetrics & Gynecology Physician29881WV
3207V00000XObstetrics & Gynecology Physician35.135295OH
4207V00000XObstetrics & Gynecology Physician14872SC
5207V00000XObstetrics & Gynecology PhysicianMD22913ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447257712
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS M ROESCH MD
Provider Business Mailing Address
First Line : 71 US ROUTE 1 STE C
Second Line :
City : SCARBOROUGH
State : ME
Zip : 04074-7174
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 181 FRANKLIN HEALTH CMNS
Second Line :
City : FARMINGTON
State : ME
Zip : 04938-6144
Country : US
Telephone Number : 207-778-6394
Fax Number : 207-778-2886
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2005
Last Update Date : 02/20/2024

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Directions to “ DR. THOMAS M ROESCH MD” Practice Location

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