Healthcare Provider Details

I. General information

NPI: 1972564995
Provider Name (Legal Business Name): JAMES K KUIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CLARK RD
TEWKSBURY MA
01876-1699
US

IV. Provider business mailing address

600 CLARK RD
TEWKSBURY MA
01876-1699
US

V. Phone/Fax

Practice location:
  • Phone: 978-851-4141
  • Fax: 978-788-7890
Mailing address:
  • Phone: 978-851-4141
  • Fax: 978-788-7911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number152454
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: