Healthcare Provider Details

I. General information

NPI: 1396310926
Provider Name (Legal Business Name): HYE CHANG RHIM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2021
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 FRUIT ST
BOSTON MA
02114-2696
US

IV. Provider business mailing address

300 1ST AVE
CHARLESTOWN MA
02129-3109
US

V. Phone/Fax

Practice location:
  • Phone: 617-952-5000
  • Fax:
Mailing address:
  • Phone: 617-697-5559
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number1016795
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: