Individual
SUZANNE F ROLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
133 BROOKLINE AVE, BOSTON, MA 02215-3904
(617) 421-1000
(617) 421-1000
Mailing address
147 MILK ST, PROVIDER ENROLLMENT DEPARTMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 421-2508
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
79576
MA
2085R0202X
Diagnostic Radiology Physician
79576
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031939
NEIGHBORHOOD HEALTH
MD
01
—
079576
TUFTS HEALTH PLAN
MD
01
—
0802501
HEALTHSOURCE
MA
01
—
AA6734
HARVARD PILGRIM
MD
01
—
J30581
B;IE CROSS BLUE SHIELD
MD
Enumeration date
04/27/2006
Last updated
01/05/2012
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