Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 204858 | MA |
Y | 208200000X | Surgeon | 204858 | MA |
Y | 208600000X | Surgeon | 204858 | MA |
N | 2086S0120X | Pediatric Surgery | 204858 | MA |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 204858 | MA |
NPI | 1144249632 |
---|---|
Provider Name | Dr. Heung B Kim |
First Address | Weston, MA 02493-1806 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 08/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0199958 | (05) | MA |
H66235 | (02) |