Ketro, Paul

Ketro, Paul is an individual health care provider with primary practice located at 425 Revere St Ell Pond Medical Associates Inc, Revere MA 02151-4543. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Ketro, Paul can be contacted via phone (781) 286-1313.

Contact Information

Primary practice address
425 Revere St Ell Pond Medical Associates Inc Revere MA 02151-4543
Phone: (781) 286-1313
Fax: (781) 286-1098
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 77202 Massachusetts

Profile Details

NPI number 1851374110
LBN Legal business name Ketro, Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2005
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851374110 NPPES
Massachusetts MEDICAID 3112004

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