Individual
JORGE M BOTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
360 MERRIMACK ST, BLDG 9, ENTRANCE I, LAWRENCE, MA 01843-1740
(978) 688-6182
(978) 689-0731
Mailing address
360 MERRIMACK ST, BLDG 9, ENTRANCE I, LAWRENCE, MA 01843-1740
(978) 688-6182
(978) 689-0731
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
76765
MA
207W00000X
Ophthalmology Physician
Primary
76765
MA
207W00000X
Ophthalmology Physician
9469
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110052237A
—
MA
05
—
3080859
—
NH
Enumeration date
11/21/2005
Last updated
05/13/2025
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