Provider Demographics
NPI:1801833488
Name:LADNER, JENNIFER H (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:H
Last Name:LADNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:90 TER HEUN DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02540
Mailing Address - Country:US
Mailing Address - Phone:508-540-0604
Mailing Address - Fax:508-457-0129
Practice Address - Street 1:90 TER HEUN DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540
Practice Address - Country:US
Practice Address - Phone:508-540-0604
Practice Address - Fax:508-457-0129
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA218613207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2017032Medicaid
043488655OtherTRICARE
218613OtherMA LICENSE
J26732OtherBCBS
10725539OtherCAQH
MA1801833488OtherUNICARE
MA1801833488OtherGREAT WEST HEALTHCARE
467287OtherTUFTS
ML0524492AOtherMA CDS
3268298OtherAETNA
MA1801833488OtherNETWORK HEALTH
LAA35789OtherMEDICARE
0038770OtherNEIGHBORHOOD HEALTH PLAN
1554097001OtherCIGNA
304922OtherHPH
MA000000029656OtherBOSTON MEDICAL CENTER
043488655OtherUNITED HEALTH
MAP00050045OtherMEDICARE ID
MAP00050045OtherMEDICARE ID
304922OtherHPH