Glen S Roseborough, MD | |
2480 Liberty St Ne, Suite 110, Salem, OR 97301-8381 | |
(503) 371-1756 | |
(503) 584-7971 |
Full Name | Glen S Roseborough |
---|---|
Gender | Male |
Speciality | Vascular Surgery |
Experience | 33 Years |
Location | 2480 Liberty St Ne, Salem, Oregon |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1518903186 | NPI | - | NPPES |
500612667 | Medicaid | OR | |
P00800072 | Other | OR | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2086S0129X | Surgery - Vascular Surgery | MD150190 (Oregon) | Primary |
208600000X | Surgery | MD150190 (Oregon) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Sentara Careplex Hospital | Hampton, VA | Hospital |
Sentara Williamsburg Regional Medical Center | Williamsburg, VA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Sentara Medical Group | 8921903923 | 1091 |
Entity Name | Sentara Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1265485270 PECOS PAC ID: 8921903923 Enrollment ID: O20031203000466 |
Mailing Address | Practice Location Address |
---|---|
Glen S Roseborough, MD 2480 Liberty St Ne, Suite 110, Salem, OR 97301-8381 Ph: (503) 371-1756 | Glen S Roseborough, MD 2480 Liberty St Ne, Suite 110, Salem, OR 97301-8381 Ph: (503) 371-1756 |
Mark Steven Peterson, MD Surgery Medicare: Medicare Enrolled Practice Location: 925 Commercial St Se Ste 102, Salem, OR 97302 Phone: 503-561-7227 Fax: 503-671-8334 | |
Dr. Peter Augusto Bernardo, M.D Surgery Medicare: Not Enrolled in Medicare Practice Location: 700 Bellevue St Se, Suite 230, Salem, OR 97301 Phone: 503-585-6586 Fax: 503-371-4180 | |
Jiyoun E Kim, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 2020 Capitol St Ne, Salem, OR 97301 Phone: 503-399-2470 Fax: 503-375-7429 | |
Eric A Laro, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5050 Skyline Village Loop S, Salem, OR 97306 Phone: 503-391-1110 Fax: 503-370-4237 | |
Dr. Patrick O'herron, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 890 Oak St Se, Salem, OR 97301 Phone: 503-561-5200 | |
Dr. Rick Dewitt Pittman, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1793 13th St Se, Salem, OR 97302 Phone: 503-362-8385 Fax: 503-362-8435 | |
Dr. Elizabeth Maryann Windell, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 665 Winter St Se, Salem, OR 97301 Phone: 503-561-2448 |