Provider Demographics
NPI:1154388239
Name:RODIG, SCOTT J (MD PHD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:RODIG
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:75 FRANCIS ST
Mailing Address - Street 2:BRIGHAM & WOMEN'S HOSPITAL, DEPT. OF PATHOLOGY, AMORY 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-6110
Mailing Address - Country:US
Mailing Address - Phone:617-732-7510
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST
Practice Address - Street 2:BRIGHAM & WOMEN'S HOSPITAL, DEPT. OF PATHOLOGY, AMORY 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6110
Practice Address - Country:US
Practice Address - Phone:617-732-7510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA213371207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology