Individual
ANDREW W POTLER
Active
Individual
ANDREW W POTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58640
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000020989
BMC HEALTHNET
MA
01
—
110224982
PALMETTO GBA - RAILROAD MEDICARE
—
05
—
3057763
—
MA
Enumeration date
09/28/2006
Last updated
10/06/2014
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