Provider Demographics
NPI:1437182607
Name:SOTREL, GINTER (MD)
Entity Type:Individual
Prefix:
First Name:GINTER
Middle Name:
Last Name:SOTREL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:147 MILK ST
Mailing Address - Street 2:PROVIDER ENROLLMENT ,9TH FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-4862
Mailing Address - Country:US
Mailing Address - Phone:617-421-6540
Mailing Address - Fax:617-421-3487
Practice Address - Street 1:147 MILK ST
Practice Address - Street 2:OB / GYN
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-4862
Practice Address - Country:US
Practice Address - Phone:617-654-7280
Practice Address - Fax:617-654-7363
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA38193207V00000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
042297845OtherUNITED HEALTH CARE
1690013OtherCIGNA
AA100942OtherHARVARD PILGRIM
042297845OtherTRICARE
MAM09019OtherBLUE CROSS BLUE SHIELD
MA2032856Medicaid
MA0014810OtherNEIGHBORHOOD HEALTH PLAN
042297845OtherGIC/UNICARE
042297845OtherGREAT WEST HEALTH CARE
MA1690013-002OtherCIGNA HEALTH CARE
038193OtherTUFTS MEDICARE PREFERRED
042297845OtherHCVM/FIRST HEALTH COVENTY
5164733OtherAETNA
MA038193OtherTUFTS
1053599OtherFALLON
MAG398OtherHARVARD PILGRIM HEALTH C
AA100942OtherHARVARD PILGRIM
MA2032856Medicaid