Kim, Ducksoo
Kim, Ducksoo is an individual health care provider with primary practice located at 1400 Vfw Pkwy , West Roxbury MA 02132-4927. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Kim, Ducksoo can be contacted via phone (857) 203-6414.Contact Information
Primary practice address
1400 Vfw Pkwy
West Roxbury MA 02132-4927
Phone: (857) 203-6414
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 41575 | Massachusetts |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 41575 | Massachusetts |
Profile Details
| NPI number | 1922055326 |
|---|---|
| LBN Legal business name | Kim, Ducksoo |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 30th, 2006 |
| Last updated | Jun 6th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922055326 | NPPES |
| Massachusetts | MEDICAID | 6171095 |
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