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Individual
THOMAS T ROESCH
Active
Individual
THOMAS T ROESCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
MA002926L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
232359401
MAIN LINE HEALTHCARE
PA
Enumeration date
02/23/2006
Last updated
06/15/2018
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