1437182607 NPI number — GINTER SOTREL MD

Table of content: GINTER SOTREL MD (NPI 1437182607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437182607 NPI number — GINTER SOTREL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOTREL
Provider First Name:
GINTER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437182607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
147 MILK ST
Provider Second Line Business Mailing Address:
PROVIDER ENROLLMENT ,9TH FLOOR
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02109-4862
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-421-6540
Provider Business Mailing Address Fax Number:
617-421-3487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
147 MILK ST
Provider Second Line Business Practice Location Address:
OB / GYN
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02109-4862
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-654-7280
Provider Business Practice Location Address Fax Number:
617-654-7363
Provider Enumeration Date:
07/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  38193 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VG0400X , with the licence number: 38193 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 042297845 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1690013 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: AA100942 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: M09019 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 2032856 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0014810 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GIC/UNICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "GREAT WEST HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1690013-002 . This is a "CIGNA HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 038193 . This is a "TUFTS MEDICARE PREFERRED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 042297845 . This is a "HCVM/FIRST HEALTH COVENTY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5164733 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 038193 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1053599 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: G398 . This is a "HARVARD PILGRIM HEALTH C" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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