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Individual

ROCHELLE BETH LOEB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
417 STATE ST, SUITE 330, BANGOR, ME 04401-6630
(207) 973-8881
(207) 973-8880
Mailing address
43 WHITING HILL RD, SUITE 300, BREWER, ME 04412-1005
(207) 973-5035

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-623
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
047955
ANTHEM OF MAINE
ME
05
313040099
ME
01
P00197441
RAILROAD MEDICARE
ME
Enumeration date
05/20/2006
Last updated
02/28/2014
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