| Provider / Organization | NPI | Date Certified |
|---|---|---|
| RYAN LEWIS KIM | 1174186530 | 2020-07-04 |
Ryan Lewis Kim is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1174186530. Registration indicates Ryan Lewis Kim is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ryan Lewis Kim MD |
| Practice Office Address | 1 BOSTON MEDICAL CTR PL BOSTON, MA US |
| Practice Office Telephone | 7863385377 |
| Mailing Address | 2 LEIGHTON ST APT 223 CAMBRIDGE, MA 021413003 US |
| Business Telephone | 7863385377 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |