Individual
IRIS KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 LAKE AVENUE NORTH, WORCESTER, MA 01655
(508) 334-1000
Mailing address
55 LAKE AVENUE NORTH, WORCESTER, MA 01655
(508) 334-1000
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036152475
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2016
Last updated
10/13/2021
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