Leidner, Rom Samuel

Leidner, Rom Samuel is an individual health care provider with primary practice located at 4805 Ne Glisan St Suite 6N40, Portland OR 97213-2933. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology & Oncology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Medical Oncology is his primary health care specialty. Leidner, Rom Samuel can be contacted via phone (503) 215-5696.

Contact Information

Primary practice address
4805 Ne Glisan St Suite 6N40 Portland OR 97213-2933
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 57.012492 Ohio
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X MD00044911 Washington
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X MD159938 Oregon

Profile Details

NPI number 1801908702
LBN Legal business name Leidner, Rom Samuel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Mar 19th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801908702 NPPES
Washington Other 0039581 LABOR & INDUSTRY
Washington Other P00287631 LABOR & INDUSTRY
Washington MEDICAID 8441743 LABOR & INDUSTRY

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