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Individual

PETER KOCH-WESER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
295 VARNUM STREET, LYNN, MA 01904
(781) 581-9200
Mailing address
PO BOX 9135, ATTN: SHARON SILVA, BROOKLINE, MA 02446-9135
(800) 927-0002

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
39668
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2047403
MA
Enumeration date
09/07/2005
Last updated
07/08/2007
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