Healthcare Provider Details

I. General information

NPI: 1396723276
Provider Name (Legal Business Name): ULRIKE B KOHLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 TREMONT ST
DUXBURY MA
02332-4738
US

IV. Provider business mailing address

95 TREMONT ST
DUXBURY MA
02332-4738
US

V. Phone/Fax

Practice location:
  • Phone: 781-934-0060
  • Fax: 781-934-7006
Mailing address:
  • Phone: 781-934-0060
  • Fax: 781-934-7006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number152205
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: