Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 158723 | MA |
NPI | 1033151360 |
---|---|
Provider Name | Stephen F Koelbel |
First Address | West Peabody, MA 01960-7190 |
Second Address | Weymouth, MA 02190-1868 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 10/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
158723 | TUFTS HEALTH CARE (01) | MA |
3188027 | (05) | MA |
68790 | HARVARD PILGRIM HEALTHCAR (01) | MA |
G57421 | (02) | |
J19651 | BLUE CROSS BLUE SHIELD (01) | MA |