Provider Demographics
NPI:1831137405
Name:INHORN, ROGER C (MD-PHD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:C
Last Name:INHORN
Suffix:
Gender:
Credentials:MD-PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GLEN COVE DR STE 360
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4272
Mailing Address - Country:US
Mailing Address - Phone:207-921-8969
Mailing Address - Fax:207-910-4407
Practice Address - Street 1:6 GLEN COVE DR STE 360
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4272
Practice Address - Country:US
Practice Address - Phone:207-921-8969
Practice Address - Fax:207-910-4407
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD16624207RX0202X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME422150099Medicaid
MEME0846Medicare ID - Type Unspecified
MEF29906Medicare UPIN
MEUX3934Medicare PIN