Provider Demographics
NPI:1548238710
Name:MEYERHARDT, JEFFREY A (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:MEYERHARDT
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:44 BINNEY ST
Mailing Address - Street 2:DANA-FARBER CANCER INST
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-632-6855
Mailing Address - Fax:617-632-5370
Practice Address - Street 1:44 BINNEY ST
Practice Address - Street 2:DANA-FARBER CANCER INST
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6013
Practice Address - Country:US
Practice Address - Phone:617-632-6855
Practice Address - Fax:617-632-5370
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA203798207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
203798OtherTUFTS
65555OtherFALLON COMMUNITY HEALTH P
3000549OtherUNITED HEALTH CARE
P00122130OtherRR MEDICARE DFCI
2921187OtherAETNA
MA0167860Medicaid
J24744OtherBCBS MA INDEMNITY BC ELEC
0449300OtherCIGNA
14800OtherHPHC DFCI ONLY
H59865Medicare UPIN
65555OtherFALLON COMMUNITY HEALTH P