Healthcare Provider Details

I. General information

NPI: 1043405442
Provider Name (Legal Business Name): AMEE RATHOD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2007
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 NEWTON ST
SOUTHBOROUGH MA
01772-1215
US

IV. Provider business mailing address

291 INDEPENDENCE DR
CHESTNUT HILL MA
02467-3628
US

V. Phone/Fax

Practice location:
  • Phone: 508-481-5500
  • Fax:
Mailing address:
  • Phone: 617-657-6430
  • Fax: 508-453-8152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number229197
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: