Provider Demographics
NPI:1174574008
Name:OSTERHAUS-HOULE, KERRI E (MD)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:E
Last Name:OSTERHAUS-HOULE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:328 SHREWSBURY ST
Mailing Address - Street 2:STE 100
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4613
Mailing Address - Country:US
Mailing Address - Phone:508-755-4861
Mailing Address - Fax:508-752-1392
Practice Address - Street 1:328 SHREWSBURY ST
Practice Address - Street 2:STE 100
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4613
Practice Address - Country:US
Practice Address - Phone:508-755-4861
Practice Address - Fax:508-752-1392
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA216676207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
80347OtherFALLON
0029540OtherNEIGHBORHOOD HEALTH
MAJ26197OtherBCBS
MA2009692Medicaid
97347502OtherNETWORK HEALTH
467483OtherTUFTS
AA9354OtherHARVARD PILGRIM
MA2009692Medicaid
467483OtherTUFTS