Individual
DR. HOLLY ROTHERMEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 FRUIT ST, YAW 6, PEDIATRIC GROUP PRACTICE, BOSTON, MA 02114-2621
(617) 726-2728
(617) 726-3948
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 726-2728
(617) 724-3948
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
150450
MA
2080P0216X
Pediatric Rheumatology Physician
Primary
150450
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150450
TUFTS HEALTH PLAN
MA
05
—
3152341
—
MA
01
—
J16594
BCBS MA
MA
Enumeration date
12/15/2005
Last updated
11/29/2012
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