Provider Demographics
NPI:1659361327
Name:MAYER, ROBERT JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:MAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:450 BROOKLINE AVE
Mailing Address - Street 2:D-1608
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-5418
Mailing Address - Country:US
Mailing Address - Phone:617-632-3474
Mailing Address - Fax:617-632-2260
Practice Address - Street 1:450 BROOKLINE AVE
Practice Address - Street 2:DANA FARBER CANCER INSTITUTE, D-1608
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5418
Practice Address - Country:US
Practice Address - Phone:617-632-3474
Practice Address - Fax:617-632-2260
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA36776207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM08749OtherBCBS MA
MA2038706Medicaid
MA730076OtherTUFTS HEALTH PLAN
MA730076OtherTUFTS HEALTH PLAN
B98640Medicare UPIN