Provider Demographics
NPI:1013128586
Name:ROBERTS-SCHULTHEIS, KIMBERLY J (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:J
Last Name:ROBERTS-SCHULTHEIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:J
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:221 CRESCENT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3425
Mailing Address - Country:US
Mailing Address - Phone:774-460-8436
Mailing Address - Fax:
Practice Address - Street 1:108 GROVE ST STE 200
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-2651
Practice Address - Country:US
Practice Address - Phone:774-460-8436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2022-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2382732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry