Provider Demographics
NPI:1326013160
Name:WHITE, RODGER MUSSER (MD)
Entity Type:Individual
Prefix:DR
First Name:RODGER
Middle Name:MUSSER
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICAL ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT STREET CLN 309
Practice Address - Street 2:ANESTHESIA ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-726-3030
Practice Address - Fax:617-724-8500
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA205463207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ24736OtherBCBS MA
MA0169251Medicaid
MA205463OtherTUFTS HEALTH PLAN
MAA33817Medicare ID - Type Unspecified
MA205463OtherTUFTS HEALTH PLAN