MEDICARE: JEAN JIHI KIM MD

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	208600000X	Surgery Physician	155016	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447258736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN JIHI KIM MD

Provider Business Mailing Address
First Line	:	475 FRANKLIN ST
Second Line	:	STE 203
City	:	FRAMINGHAM
State	:	MA
Zip	:	01702-6265
Country	:	US
Telephone Number	:	508-879-4407
Fax Number	:	508-620-9395

Provider Business Practice Location Address
First Line	:	475 FRANKLIN ST
Second Line	:	STE 203
City	:	FRAMINGHAM
State	:	MA
Zip	:	01702-6265
Country	:	US
Telephone Number	:	508-879-4407
Fax Number	:	508-620-9395

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	05/24/2010

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Directions to “ JEAN JIHI KIM MD” Practice Location

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