Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 49598 | MA |
NPI | 1013967140 |
---|---|
Provider Name | Kathleen E Koehler |
First Address | Hyannis, MA 02601-1866 |
Second Address | Hyannis, MA 02601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 18/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2029341 | (05) | MA |
A57986 | (02) | |
AA6332 | HPHC (01) | MA |
J04688 | BCBS (01) | MA |