Individual
THERESE IDA HATTEMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
108 CHURCHILL AVE, ARLINGTON, MA 02476-7822
(781) 488-3303
Mailing address
108 CHURCHILL AVE, ARLINGTON, MA 02476-7822
(781) 488-3303
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
56769
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56769
MEDICAL LICENSE
MA
01
—
J08558
BLUE CROSS BLUE SHIELD
MA
Enumeration date
04/16/2007
Last updated
07/08/2007
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