Individual
DR. JOHN ELLERY MUNZENRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, NPT 107 RADIATION ONCOLOGY, BOSTON, MA 02114-2696
(617) 726-6876
(617) 726-2098
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
32285
MA
2085R0203X
Therapeutic Radiology Physician
Primary
32285
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033285
TUFTS HEALTH PLAN
MA
05
—
3059243
—
MA
01
—
M07698
BCBS MA
MA
Enumeration date
07/10/2006
Last updated
09/11/2025
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