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General NPI Number Information
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NPI Number | 1588012223
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Entity Type | Individual
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Provider Name | MEGHAN LORRAINE RUDDER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 09/29/2021
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Provider Practice Location Address
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Address Line | 850 BOYLSTON ST
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City | CHESTNUT HILL
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State | MA
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Zip | 02467-2477
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Country | US
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Telephone | 617-732-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 2 CHESTNUT ST APT 12
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City | CAMBRIDGE
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State | MA
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Zip | 02139-4847
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Country | US
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Telephone | 978-500-8510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 267507
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 288209
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License Number State | MA
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