Individual
DR. PAUL ALFRED BOEPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT STREET, YAW 6C PEDIATRIC ENDOCRINE ASSOCIATES, BOSTON, MA 02114
(617) 726-2909
(617) 724-0581
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-2909
(617) 724-0581
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
52300
MA
2080P0205X
Pediatric Endocrinology Physician
Primary
52300
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6186734
—
MA
01
—
724780
TUFTS HEALTH PLAN
MA
01
—
J04164
BCBS MA
MA
Enumeration date
12/27/2005
Last updated
11/30/2012
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