Hertl, Martin
Hertl, Martin is an individual health care provider with primary practice located at 55 Fruit St White 543, Boston MA 02114-2621. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Transplant Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Hertl, Martin can be contacted via phone (617) 726-3664.Contact Information
Primary practice address
55 Fruit St White 543
Boston MA 02114-2621
Phone: (617) 726-3664
Fax: (617) 724-5993
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Transplant Surgery | 204F00000X | 042.0012780 | Vermont |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 219964 | Massachusetts |
Profile Details
| NPI number | 1366412017 |
|---|---|
| LBN Legal business name | Hertl, Martin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 25th, 2006 |
| Last updated | Oct 29th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366412017 | NPPES |
| Massachusetts | Other | J27207 | BCBS MA |
| Massachusetts | MEDICAID | 2037840 | BCBS MA |
| Massachusetts | Other | 468642 | BCBS MA |
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