Provider Demographics
NPI:1104927623
Name:YAGER, PHOEBE HILDRETH (MD)
Entity type:Individual
Prefix:DR
First Name:PHOEBE
Middle Name:HILDRETH
Last Name:YAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
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 1:175 CAMBRIDGE STREET
Practice Address - Street 2:CPZS-5
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:617-724-4380
Practice Address - Fax:617-724-4391
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-11-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA216176208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2012316Medicaid
MAJ26342OtherBCBS MA
MA216176OtherTUFTS HEALTH PLAN
MAA35720Medicare ID - Type Unspecified
H89600Medicare UPIN