Individual
DR. KIM D HOUDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
175 CONNORS ST, GARDNER, MA 01440-2637
(978) 410-6100
Mailing address
175 CONNORS ST, GARDNER, MA 01440-2637
(978) 410-6100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
74555
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320815
—
MA
01
—
221868
UGS
MA
01
—
M18970
BLUE SHIELD OF MA
MA
Enumeration date
11/09/2005
Last updated
05/29/2008
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