Kim, Candace

Kim, Candace is an individual health care provider with primary practice located at 55 Lake Ave N , Worcester MA 01655-0002. She recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as her primary health care specialty. Kim, Candace can be contacted via phone (508) 334-1000.

Contact Information

Primary practice address
55 Lake Ave N Worcester MA 01655-0002
Phone: (508) 334-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X C54498 California
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 224029 Massachusetts

Profile Details

NPI number 1952377079
LBN Legal business name Kim, Candace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Sep 7th, 2021 - about 5 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 1952377079 NPPES
Massachusetts MEDICAID 2108739

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