Individual
KAI MITHOEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
40 ALLIED DRIVE, DED HAM, MA 02026
(617) 264-1100
(617) 264-1101
Mailing address
40 ALLIED DRIVE, DEDHAM, MA 02026
(617) 264-1100
(617) 264-1101
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
212397
MA
207X00000X
Orthopaedic Surgery Physician
228933-1
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
212397
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198510
—
MA
Enumeration date
01/29/2006
Last updated
12/28/2023
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