Individual
MARK DAVID KETTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 HARRISON AVE, BUILDING FGH-3 ROOM 203, BOSTON, MA 02118
(617) 638-6610
(617) 638-6616
Mailing address
820 HARRISON AVE, BUILDING FGH-3 ROOM 203, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
234438
MA
2085R0202X
Diagnostic Radiology Physician
Primary
MD15140
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018593
—
OR
Enumeration date
07/31/2006
Last updated
01/31/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us