Crocker, Roderick H

Crocker, Roderick H is an individual health care provider with primary practice located at 300 Mount Auburn St Ste 519, Cambridge MA 02138-5600. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Crocker, Roderick H can be contacted via phone (617) 547-4400.

Contact Information

Primary practice address
300 Mount Auburn St Ste 519 Cambridge MA 02138-5600
Phone: (617) 547-4400
Fax: (617) 576-1076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 55453 Massachusetts

Profile Details

NPI number 1053310367
LBN Legal business name Crocker, Roderick H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2005
Last updated Jun 13th, 2016 - about 8 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 1053310367 NPPES
Massachusetts MEDICAID 3009700

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