Individual
YOUNG SOO KIM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2141 BOSTON RD, WILBRAHAM, MA 01095
(413) 599-4994
(413) 599-4969
Mailing address
PO BOX 2608, SPRINGFIELD, MA 01101
(413) 599-4994
(413) 599-4969
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
45909
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000025213
BOSTON MEDICAL
MA
05
—
2070804
—
MA
01
—
H11015
BS
MA
Enumeration date
04/20/2006
Last updated
07/08/2007
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