Individual
DR. MIRA KAUTZKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
15 PARKMAN ST, SUITE 645, WACC, BOSTON, MA 02114
(617) 724-0646
(617) 724-0656
Mailing address
15 PARKMAN ST, SUITE 645, WACC, BOSTON, MA 02114
(617) 724-0646
(617) 724-0656
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
242083
MA
207R00000X
Internal Medicine Physician
MD-070882-L
PA
Other
Enumeration date
08/15/2005
Last updated
07/19/2010
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