Basic Information
Provider Information
NPI: 1063859221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROGERS
FirstName: ROBERT
MiddleName: S
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MASSACHUSETTS GENERAL HOSPITAL
Address2: 55 FRUIT ST.
City: BOSTON
State: MA
PostalCode: 02114
CountryCode: US
TelephoneNumber: 6177262865
FaxNumber:  
Practice Location
Address1: MASSACHUSETTS GENERAL HOSPITAL
Address2: 55 FRUIT ST.
City: BOSTON
State: MA
PostalCode: 02114
CountryCode: US
TelephoneNumber: 6177262865
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/29/2013
LastUpdateDate: 05/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X265824MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X265824MAN Allopathic & Osteopathic PhysiciansHospitalist 
207RP1001X265824MAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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