Koroshetz, Walter Joseph
Koroshetz, Walter Joseph is an individual health care provider with primary practice located at 55 Fruit St Vbk 915, Boston MA 02114-2621. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Vascular Neurology. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Koroshetz, Walter Joseph can be contacted via phone (617) 726-7413.Contact Information
Primary practice address
55 Fruit St Vbk 915
Boston MA 02114-2621
Phone: (617) 726-7413
Fax: (617) 726-2353
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 50968 | Massachusetts |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 50968 | Massachusetts |
| Allopathic & Osteopathic Physicians / Vascular Neurology | 2084V0102X | 50968 | Massachusetts |
Profile Details
| NPI number | 1255312211 |
|---|---|
| LBN Legal business name | Koroshetz, Walter Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 8th, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1255312211 | NPPES |
| Massachusetts | Other | J05512 | BCBS MA |
| Massachusetts | Other | 050968 | BCBS MA |
| Massachusetts | MEDICAID | 3014916 | BCBS MA |
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