Provider Demographics
NPI:1013929082
Name:ROBERTS, THOMAS G JR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:G
Last Name:ROBERTS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN 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 1:100 BLOSSOM STREET
Practice Address - Street 2:COX 640 HEMATOLOGY ONCOLOGY ASSOCIATES
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2617
Practice Address - Country:US
Practice Address - Phone:617-726-7423
Practice Address - Fax:617-724-7135
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA205670207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2010232Medicaid
MAJ24720OtherBCBS OF MA
MA409654OtherTUFTS HEALTH PLAN
MAA35431Medicare ID - Type Unspecified
H85990Medicare UPIN