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General NPI Number Information
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NPI Number | 1174655914
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Entity Type | Individual
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Provider Name | PETER SEIHWAN KIM MD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 840 WINTER ST
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City | WALTHAM
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State | MA
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Zip | 02451-1433
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Country | US
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Telephone | 781-890-2133
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Fax | 781-890-2177
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Provider Business Mailing Address
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Address Line | 71 BORDER RD STE 300
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City | WALTHAM
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State | MA
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Zip | 02451-1044
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Country | US
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Telephone | 781-890-2133
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Fax | 781-890-2177
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 336078195
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 249412
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | 249412
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License Number State | MA
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