| Leslie Roub, | |
| 144 State St, Portland, ME 04101-3776 | |
| (207) 879-3000 | |
| Not Available | 
| Full Name | Leslie Roub | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 144 State St, Portland, Maine | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1396722401 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | MD019570E (Pennsylvania) | Primary | 
| 2085R0202X | Radiology - Diagnostic Radiology | 010222 (Maine) | Secondary | 
| Entity Name | Upmc Altoona Regional Health Services, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1396724217 PECOS PAC ID: 5395659312 Enrollment ID: O20040312000257 | 
| Entity Name | Tyrone Hospital | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1659472447 PECOS PAC ID: 4183619885 Enrollment ID: O20040420000610 | 
| Entity Name | Mount Nittany Medical Center Health Services Inc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1598992554 PECOS PAC ID: 8426136797 Enrollment ID: O20081021000240 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Leslie Roub, Po Box 1849, Lewiston, ME 04241-1849 Ph: () - | Leslie Roub, 144 State St, Portland, ME 04101-3776 Ph: (207) 879-3000 | 
| Michael O'malley Quinn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 | |
| Elena Leah Resnick, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 | |
| Matthew D Ralston, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2571 | |
| Jerald Christopher Kuhn, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 144 State St, Portland, ME 04101 Phone: 207-879-3000 | |
| Whitney H Beeler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-4735 Fax: 207-662-6388 | |
| David Russell Langdon, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 144 State St, Portland, ME 04101 Phone: 207-879-3000 | |
| Ethan M Dobrow, MD Radiology Medicare: Medicare Enrolled Practice Location: 22 Bramhall St, Portland, ME 04102 Phone: 207-662-2526 |