Kim, Stefan Sungsoo

Kim, Stefan Sungsoo is an individual health care provider with primary practice located at 41 Mall Rd Lahey Clinic, Burlington MA 01805-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Kim, Stefan Sungsoo can be contacted via phone (781) 744-5171.

Contact Information

Primary practice address
41 Mall Rd Lahey Clinic Burlington MA 01805-0001
Phone: (781) 744-5171
Fax: (781) 744-3547
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 232685 Massachusetts

Profile Details

NPI number 1952500191
LBN Legal business name Kim, Stefan Sungsoo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2007
Last updated Jun 21st, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952500191 NPPES
Massachusetts MEDICAID 110076038A

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