Individual
KATHERINE KIMI MIURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 CUMMINGS CTR, SUITE 423-G, BEVERLY, MA 01915-6115
(978) 594-1662
(978) 336-5887
Mailing address
100 CUMMINGS CTR, SUITE 423-G, BEVERLY, MA 01915-6115
(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
—
1457642894
NPI TYPE 2
MA
01
—
1801853007
NPI TYPE 1
MA
05
—
3156486
—
MA
Enumeration date
05/01/2006
Last updated
02/10/2016
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