Provider Demographics
NPI:1396723276
Name:KOHLER, ULRIKE B (MD)
Entity type:Individual
Prefix:MRS
First Name:ULRIKE
Middle Name:B
Last Name:KOHLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 TREMONT ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4738
Mailing Address - Country:US
Mailing Address - Phone:781-934-0060
Mailing Address - Fax:781-934-7006
Practice Address - Street 1:95 TREMONT ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4738
Practice Address - Country:US
Practice Address - Phone:781-934-0060
Practice Address - Fax:781-934-7006
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA152205207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3162079Medicaid
MAJ17096OtherBLUE CROSS BLUE SHIELD MA
MA66049OtherHARVARD PILGRIM HEALTHCAR
MA152205OtherTUFTS HEALTH PLAN
MAA21633Medicare PIN
MAG33676Medicare UPIN