Healthcare Provider Details

I. General information

NPI: 1801864202
Provider Name (Legal Business Name): KIMBERLY STEGMAIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 BINNEY STREET
BOSTON MA
02115
US

IV. Provider business mailing address

49 PRINCE STREET #1
JAMAICA PLAIN MA
02130
US

V. Phone/Fax

Practice location:
  • Phone: 617-632-4985
  • Fax: 617-632-4850
Mailing address:
  • Phone: 617-983-3943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number160019
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: