Individual
RODERICK H CROCKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 MOUNT AUBURN ST, STE 519, CAMBRIDGE, MA 02138-5600
(617) 547-4400
(617) 576-1076
Mailing address
300 MOUNT AUBURN STREET, SUITE #519, CAMBRIDGE, MA 02138-5600
(617) 547-4400
(617) 576-1076
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
55453
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3009700
—
MA
Enumeration date
07/19/2005
Last updated
06/13/2016
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