Individual
DR. WALTER JOSEPH KOROSHETZ
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, VBK 915, BOSTON, MA 02114-2621
(617) 726-7413
(617) 726-2353
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
50968
MA
207RN0300X
Nephrology Physician
50968
MA
2084V0102X
Vascular Neurology Physician
Primary
50968
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050968
TUFTS HEALTH PLAN
MA
05
—
3014916
—
MA
01
—
J05512
BCBS MA
MA
Enumeration date
11/08/2005
Last updated
09/11/2025
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