Individual
DR. POLYXENI D KOUTKIA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
0 EMERSON PLACE E00-112, STE 112, NEUROENDOCRINE, BOSTON, MA 02114-2241
(617) 726-7948
(617) 726-1241
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
215954
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0208787
—
MA
01
—
468749
TUFTS HEALTH PLAN
MA
01
—
J27155
BCBS MA
MA
Enumeration date
10/26/2005
Last updated
07/08/2007
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