Provider Demographics
NPI:1457342024
Name:KUTER, DAVID JOHN (MD DPHIL)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:KUTER
Suffix:
Gender:M
Credentials:MD DPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-724-6193
Mailing Address - Fax:617-643-1915
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 7B HEMATOLOGY ONCOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-724-6193
Practice Address - Fax:617-643-1915
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA47157207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ02750OtherBCBS MA
MA6184952Medicaid
MA724815OtherTUFTS HEALTH PLAN
MA6184952Medicaid
MA724815OtherTUFTS HEALTH PLAN