MEDICARE: DR. ALLISON SHIELDS KIMBALL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	279260	MA

General Provider Information

NPI Number	:	1053724096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON SHIELDS KIMBALL M.D.

Provider Business Mailing Address
First Line	:	55 FRUIT ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02114-2696
Country	:	US
Telephone Number	:	617-726-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 FRANCIS ST
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02115-6110
Country	:	US
Telephone Number	:	617-732-5500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2014
Last Update Date	:	03/10/2026

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