Richard Rox Anderson, MD
Individual provider Active NPI Dermatology Physician · Boston, MA
NPI 1700869831 · NPPES record last updated Dec 20, 2012
Key facts
- NPI
- 1700869831
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dermatology Physician 207N00000X
- License
- 76342 (MA)
- Practice address
- 50 Staniford St
Floor #2
Boston, MA 02114-2517 - Phone
- (617) 726-6960
- Fax
- (617) 724-6970
- NPI assigned
- Nov 22, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76342 | MA | MD | Dermatology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 76342 | MA | Yes |
Addresses
Primary practice location
50 Staniford St
Floor #2
Boston, MA 02114-2517
Mailing address
PO Box 9142
Mass General Physician Organization
Charlestown, MA 02129-9142
Phone (617) 724-6960
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076342 | Other | MA | TUFTS HEALTH PLAN |
| J08730 | Other | MA | BCBS MA |
| 3052052 | Medicaid | MA |
Other providers in Boston, MA
- Monique Rochelle Anderson
- Nathan Putnam Anderson
- Paul J Anderson
- Philip D Anderson
- Rachel Ellen Poritsky Anderson
- Ronald J Anderson
- Samuel Anderson
- Sara Carmer Anderson
- Shawn Thomas Anderson
- Shonah Anderson
All providers in Boston, MA · Dermatology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.