Individual
JOHN H ROEDIGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1250 FOREST AVE, PORTLAND, ME 04103-1897
(207) 797-5753
(207) 797-9571
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD8727
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040512
ANTHEM
ME
01
—
1044199
AETNA
ME
05
—
302230099
—
ME
01
—
B86271
HARVARD PILGRIM
ME
Enumeration date
10/13/2005
Last updated
04/03/2012
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