Provider Demographics
NPI:1679509640
Name:PADERA, ROBERT F (MD PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:PADERA
Suffix:
Gender:M
Credentials:MD PHD
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Mailing Address - Street 1:75 FRANCIS ST AMORY 3
Mailing Address - Street 2:BRIGHAM & WOMEN'S HOSPITAL DEPARTMENT OF PATHOLOGY
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115
Mailing Address - Country:US
Mailing Address - Phone:617-732-7510
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST AMORY 3
Practice Address - Street 2:BRIGHAM & WOMEN'S HOSPITAL DEPARTMENT OF PATHOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-732-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA219064207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology