Individual
DR. STEPHANIE LOUISE KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(617) 629-6330
(617) 629-6128
Mailing address
40 HOLLAND STREET, SOMERVILLE, MA 02144
(617) 629-6330
(617) 629-6128
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
220863
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2086115
—
MA
Enumeration date
11/08/2006
Last updated
07/18/2011
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