Provider Demographics
NPI:1275590515
Name:COLE, KIMBERLY C (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:C
Last Name:COLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 W CUMMINGS PARK STE 4050
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6372
Mailing Address - Country:US
Mailing Address - Phone:781-787-3003
Mailing Address - Fax:781-281-2406
Practice Address - Street 1:800 W CUMMINGS PARK STE 4050
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6372
Practice Address - Country:US
Practice Address - Phone:781-787-3003
Practice Address - Fax:781-281-2406
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60583207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3621588-001OtherCIGNA
MA060583OtherTUFTS HEALTH PLAN
MA0014804OtherNEIGHBORHOOD HEALTH PLAN
MA3188493Medicaid
MAAA7837OtherHARVARD PILGRIM
MAJ14436OtherBLUE CROSS
MA3188493Medicaid
MA060583OtherTUFTS HEALTH PLAN
MAJ14436Medicare PIN