Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 74649 | MA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 74649 | MA |
NPI | 1053384693 |
---|---|
Provider Name | Thomas Eugene Rohrer |
First Address | Chestnut Hill, MA 02467-2116 |
Second Address | Chestnut Hill, MA 02467-2116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0300555 | UNITED (01) | |
074649 | TUFTS (01) | MA |
2694775 | AETNA (01) | |
401218 | HPHC (01) | MA |
5007269004 | CIGNA (01) | |
F01095 | (02) | |
J11685 | BLUE SHIELD (01) | MA |