Provider Demographics
NPI:1629052410
Name:KUTER, IRENE (MD DPHIL)
Entity Type:Individual
Prefix:DR
First Name:IRENE
Middle Name:
Last Name:KUTER
Suffix:
Gender:F
Credentials:MD DPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-0287
Mailing Address - Fax:617-726-2894
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:MASSACHUSETTS GENERAL HOSPITAL, YAWKEY 9A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-6500
Practice Address - Fax:617-724-1079
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA50927207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA050927OtherTUFTS HEALTH PLAN
MA6175058Medicaid
MAJ02430OtherBCBS MA
MA050927OtherTUFTS HEALTH PLAN
MAJ02430Medicare ID - Type Unspecified