Organization
KATHERINE K. MIURA, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KATHERINE KIMI MIURA M.D. (OWNER)
(978) 594-1662
Entity
Organization
Contact information
Practice address
564 LORING AVE, UNIT 2, SALEM, MA 01970-4276
(978) 594-1662
(978) 336-5887
Mailing address
564 LORING AVE, UNIT 2, SALEM, MA 01970-4276
(978) 594-1662
(978) 336-5887
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
81163
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801853007
NPI TYPE 1
MA
05
—
3156486
—
MA
Enumeration date
04/19/2011
Last updated
04/19/2011
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