Individual
TAE KYU UHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1153 CENTRE ST, BOSTON, MA 02130-3446
(215) 955-8420
(215) 503-0429
Mailing address
1153 CENTER ST, BOSTON, MA 02130
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
1015086
MA
2084P0800X
Psychiatry Physician
MD475135
PA
2084P0800X
Psychiatry Physician
MT217450
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2019
Last updated
06/03/2024
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