Basic Information
| Provider Information | |||||||||
| NPI: | 1437182607 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOTREL | ||||||||
| FirstName: | GINTER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 147 MILK ST | ||||||||
| Address2: | PROVIDER ENROLLMENT ,9TH FLOOR | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021094862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174216540 | ||||||||
| FaxNumber: | 6174213487 | ||||||||
| Practice Location | |||||||||
| Address1: | 147 MILK ST | ||||||||
| Address2: | OB / GYN | ||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021094862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176547280 | ||||||||
| FaxNumber: | 6176547363 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 03/12/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 38193 | MA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VG0400X | 38193 | MA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 042297845 | 01 | UNITED HEALTH CARE | OTHER | 1690013 | 01 | CIGNA | OTHER | AA100942 | 01 | HARVARD PILGRIM | OTHER | 042297845 | 01 | TRICARE | OTHER | M09019 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 2032856 | 05 | MA | MEDICAID | 0014810 | 01 | MA | NEIGHBORHOOD HEALTH PLAN | OTHER | 042297845 | 01 | GIC/UNICARE | OTHER | 042297845 | 01 | GREAT WEST HEALTH CARE | OTHER | 1690013-002 | 01 | MA | CIGNA HEALTH CARE | OTHER | 038193 | 01 | TUFTS MEDICARE PREFERRED | OTHER | 042297845 | 01 | HCVM/FIRST HEALTH COVENTY | OTHER | 5164733 | 01 | AETNA | OTHER | 038193 | 01 | MA | TUFTS | OTHER | 1053599 | 01 | FALLON | OTHER | G398 | 01 | MA | HARVARD PILGRIM HEALTH C | OTHER |