Provider Demographics
NPI:1427068873
Name:VETTERS, RALPH GILLILAND (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:GILLILAND
Last Name:VETTERS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1340 BOYLSTON ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-4302
Mailing Address - Country:US
Mailing Address - Phone:617-247-7555
Mailing Address - Fax:617-938-0033
Practice Address - Street 1:1340 BOYLSTON ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-4302
Practice Address - Country:US
Practice Address - Phone:617-247-7555
Practice Address - Fax:617-938-0033
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2024-09-17
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Provider Licenses
StateLicense IDTaxonomies
MA227788208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA227788OtherSTATE MEDICAL LICENSE