Kim, Allis

Kim, Allis is an individual health care provider with primary practice located at 65 Fremont St , Marlborough MA 01752-1271. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Allopathic & Osteopathic Physicians / Orthopaedic Trauma. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Kim, Allis can be contacted via phone (508) 485-3665.

Contact Information

Primary practice address
65 Fremont St Marlborough MA 01752-1271
Phone: (508) 485-3665
Fax: (508) 485-0899
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 157401 Massachusetts
Allopathic & Osteopathic Physicians / Orthopaedic Trauma 207XX0801X 157401 Massachusetts

Profile Details

NPI number 1053400879
LBN Legal business name Kim, Allis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Jul 10th, 2012 - about 13 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 1053400879 NPPES
New York Other 7446715 AETNA
New York Other 10100115 AETNA
New York Other 658G61 AETNA
New York MEDICAID 02670579 AETNA
New York Other 790107 AETNA
New York Other 000409533001 AETNA

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