MEDICARE: JOERG RATHMANN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0000X	Hematology (Internal Medicine) Physician	040849	CT
2	207RH0003X	Hematology & Oncology Physician	040849	CT
3	207RX0202X	Medical Oncology Physician	040849	CT
4	207RH0003X	Hematology & Oncology Physician	10433	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568465532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOERG RATHMANN MD

Provider Business Mailing Address
First Line	:	2300 SOUTHWOOD DR
Second Line	:
City	:	NASHUA
State	:	NH
Zip	:	03063-1899
Country	:	US
Telephone Number	:	603-577-4170
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:
City	:	LEBANON
State	:	NH
Zip	:	03756-0001
Country	:	US
Telephone Number	:	603-650-5000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/19/2024

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