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Individual

DR. MARTIN HERTL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
55 FRUIT ST, WHITE 543, BOSTON, MA 02114-2621
(617) 726-3664
(617) 724-5993
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTON, MA 02129-9142
(617) 724-0287
(617) 726-2894

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
042.0012780
VT
208600000X
Surgery Physician
Primary
219964
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2037840
MA
01
468642
TUFTS HEALTH PLAN
MA
01
J27207
BCBS MA
MA
Enumeration date
01/25/2006
Last updated
10/29/2020
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