Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 207779 | MA |
NPI | 1356343032 |
---|---|
Provider Name | David H Kim |
First Address | Hingham, MA 02043-0086 |
Second Address | Roxbury Crossing, MA 02120-2847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 30/03/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0184721 | (05) | MA |
G02439 | (02) | MA |