Provider Demographics
NPI:1093771495
Name:HENTSCHEL, DIRK M (MD)
Entity type:Individual
Prefix:
First Name:DIRK
Middle Name:M
Last Name:HENTSCHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BLACKFAN CIR
Mailing Address - Street 2:BWH RENAL DIVISON, HIM-550
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5713
Mailing Address - Country:US
Mailing Address - Phone:617-525-5968
Mailing Address - Fax:
Practice Address - Street 1:4 BLACKFAN CIR
Practice Address - Street 2:BWH RENAL DIVISON, HIM-550
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5713
Practice Address - Country:US
Practice Address - Phone:617-525-5968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-25
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA219320207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology