Provider Demographics
NPI:1245089705
Name:KIM, SEOIN (MD)
Entity type:Individual
Prefix:MS
First Name:SEOIN
Middle Name:
Last Name:KIM
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 LINCOLN STREET, METROWEST MEDICAL CENTER, ATTN: RHO
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702
Mailing Address - Country:US
Mailing Address - Phone:508-383-1572
Mailing Address - Fax:
Practice Address - Street 1:115 LINCOLN STREET, METROWEST MEDICAL CENTER, ATTN: RHO
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702
Practice Address - Country:US
Practice Address - Phone:508-383-1572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-16
Last Update Date:2025-03-03
Deactivation Date:2025-01-13
Deactivation Code:
Reactivation Date:2025-03-03
Provider Licenses
StateLicense IDTaxonomies
MA3016366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine