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General NPI Number Information
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NPI Number | 1649465683
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Entity Type | Organization
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Legal Business Name | MARTIN E KOUTCHER MD PC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 05/22/2012
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Provider Practice Location Address
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Address Line | 1328 W RITNER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19148-3537
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Country | US
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Telephone | 215-336-0655
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Fax | 215-271-2588
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Provider Business Mailing Address
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Address Line | 1328 W RITNER ST
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City | PHILADELPHIA
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State | PA
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Zip | 19148-3537
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Country | US
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Telephone | 215-336-0655
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Fax | 215-271-2588
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTIN E KOUTCHER
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Credential | MD PC FACR
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Telephone | 215-336-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD010174E
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License Number State | PA
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