Provider Demographics
NPI:1922089648
Name:KOTCH, INGRID E (MD)
Entity Type:Individual
Prefix:DR
First Name:INGRID
Middle Name:E
Last Name:KOTCH
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 1:141 LONGWATER DR
Mailing Address - Street 2:
Mailing Address - City:NORWELL
Mailing Address - State:MA
Mailing Address - Zip Code:02061-1632
Mailing Address - Country:US
Mailing Address - Phone:781-878-5200
Mailing Address - Fax:
Practice Address - Street 1:51 PERFORMANCE DR
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3104
Practice Address - Country:US
Practice Address - Phone:781-682-8000
Practice Address - Fax:781-335-1412
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207333207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA042297845OtherGIC UNICARE
MA7525288OtherAETNA
MAB21092601OtherCIGNA
MA207333OtherTUFTS MEDICARE PREFERRED
MAA31939OtherMEDICARE
MA0112224Medicaid
MA042297845OtherDOC FIRST
MA042297845OtherUNITED HEALTH CARE
MA042297845OtherTRICARE
MA0021776OtherNHP
MA131272OtherHARVARD PILGRIM
MA207333OtherTUFTS HEALTH CARE
MA042297845OtherHCVM
MA042297845OtherGREAT WEST HEALTH CARE
MAJ23058OtherBCBSMA
MA042297845OtherPRIVATE HEALTHCARE SYSTEM
MA51652OtherFALLON