Individual
MARK WILLIAM RODEHAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1330 BEACON ST, SUITE 263, BROOKLINE, MA 02446-3282
(617) 566-2859
Mailing address
127 WINTHROP RD, 4, BROOKLINE, MA 02445-4678
(617) 566-2859
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36905
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2033917
—
MN
Enumeration date
07/19/2006
Last updated
07/08/2007
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