Individual
JOO Y KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
485 ARSENAL ST, INTERNAL MEDICINE, WATERTOWN, MA 02472-5091
(617) 972-5200
(617) 972-5512
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
213300
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2013410
—
MA
01
—
213300
TUFTS
MA
01
—
694838
HARVARD PILGRIM
MA
01
—
J25579
BLUE CROSS
MA
Enumeration date
03/16/2006
Last updated
06/27/2011
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