Mark David Kettler in Boston - Diagnostic Radiology
Mark David Kettler - NPI 1790790202
Mark David Kettler is a Diagnostic Radiology in Boston, Massachusetts. Mark David Kettler practices all healthcare services and medical treatments related to Diagnostic Radiology. The NPI Number for Mark David Kettler is 1790790202. The last update date is 2008-01-31.
Mark David Kettler's current location address is 820 Harrison Ave, Boston, Massachusetts. You can contact this provider via phone number 6176386610 and fax number 6176386616. The mailing address for Mark David Kettler is 820 Harrison Ave, Boston, Massachusetts. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark David Kettler |
|---|---|
| Address | 820 Harrison Ave, Boston, Massachusetts |
| Phone Number | 6176386610 |
| Fax Number | 6176386616 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1790790202 |
|---|---|
| Provider Enumeration Date | 2006-07-31 |
| Last Updated Date | 2008-01-31 |
Provider Mailing Address Detail
| Address | 820 Harrison Ave |
|---|---|
| City | Boston |
| State | Massachusetts (MA) |
| Post Code | 2118 |
| Phone Number | 6176386610 |
| Fax Number | 6176386616 |
Provider's Primary Taxonomy Detail
| Speciality | Diagnostic Radiology |
|---|---|
| Taxonomy | 2085R0202X |
| Licence No | MD15140 |
|
Definition: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 18593 | OR | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Mark David Kettler by the Centers for Medicare & Medicaid Services?
The Mark David Kettler has been issued the NPI (National Provider Identifier) 1790790202. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Mark David Kettler is geographically located?
The Mark David Kettler is physically situated at the following location: 820 Harrison Ave, Boston, MA, 2118.
What is the Mark David Kettler's area of specialization and corresponding taxonomy classification?
The Mark David Kettler's specialty field is Diagnostic Radiology, and it falls under the taxonomy code 2085R0202X, which categorizes healthcare providers based on their specialties.
On what date did the Mark David Kettler receive its 1790790202 assignment from the Centers for Medicare & Medicaid Services?
The Mark David Kettler was assigned its 1790790202 by the Centers for Medicare & Medicaid Services on 2006-07-31.
When was the information pertaining to Mark David Kettler most recently updated or revised?
The details related to Mark David Kettler, including its address, specialty, and other relevant information, were last updated or revised on 2008-01-31.