DR. PETER KIM (NPI# 1669754925) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669754925 |
| Entity Type | Individual |
| Full Name | DR. PETER KIM |
| Credential | MD |
| Practice Address |
2 Dudley St Ste 190 Providence RI 02905-3248 |
| Mailing Address |
Po Box 16149 Rumford RI 02916-0697 |
| Practice Telephone | 4015538341 |
| Practice Fax Number | 4018682319 |
| Mailing Telephone | 4014539625 |
| Mailing Fax Number | 4014357069 |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2020-02-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | MD039738 | DC | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
MD16869 | RI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295298891 | Peter Y Kim | Specialist | 1380 Howard St # 201c, San Francisco, CA 94103-2638 | 2019-04-10 |
| 1922518208 | Peter Kim | Dentist | 15737 E Prentice Dr, Centennial, CO 80015-4264 | 2017-10-02 |
| 1336593391 | Peter Eugene Kim | Student in an Organized Health Care Education/Training Program | 47 New Scotland Avenue, Dept of Radiology, Albany, NY 12208 | 2016-04-15 |
| 1821475369 | Peter Eusuk Kim | Dentist | 4649 Loma Del Sur Dr, Apt 3307, El Paso, TX 79934-3350 | 2015-05-05 |
| 1497041438 | Peter P Kim | Orthotic Fitter | 720 S. Ramona Ave., Suite 103, Corona, CA 92879-2147 | 2011-06-28 |
| 1184915761 | Peter Hwa Kim | Acupuncturist | 801 N Tustin Ave Ste 501, Santa Ana, CA 92705-3609 | 2011-04-29 |
| 1821257528 | Peter Simon Kim | Podiatrist | 5220 Pacific Concourse Dr, Ste 120, Los Angeles, CA 90045-6244 | 2008-06-06 |
| 1164603965 | Peter Yeon-seong Kim | Internal Medicine | 1400 Pressler, Suite Fct 11.5012, Md Anderson Cancer - Pickens Academic Tower, Houston, TX 77030 | 2007-11-20 |
| 1972725844 | Peter M Kim | Dentist | 2415 G St, Bakersfield, CA 93301-2809 | 2007-05-02 |
| 1053454983 | Peter Sang Kim | Acupuncturist | 929 N Western Ave, Los Angeles, CA 90029-3215 | 2007-02-14 |
| Street Address |
2 DUDLEY ST STE 190 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905-3248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881715944 | Elizabeth J Renaud | Surgery | 2 Dudley St Ste 190, Providence, RI 02905-3248 | 2007-04-03 |
| 1417277161 | Julie Monteagudo | Surgery | 2 Dudley St Ste 190, Providence, RI 02905-3248 | 2010-06-04 |
| 1356673271 | Joshua Nathanael Honeyman | Surgery | 2 Dudley St Ste 190, Providence, RI 02905 | 2010-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881715944 | Elizabeth J Renaud | Surgery | 2 Dudley St Ste 190, Providence, RI 02905-3248 | 2007-04-03 |
| 1316944127 | Arlet G. Kurkchubasche | Surgery | 2 Dudley Street, Suite 190, Providence, RI 02905 | 2005-07-07 |
| 1417277161 | Julie Monteagudo | Surgery | 2 Dudley St Ste 190, Providence, RI 02905-3248 | 2010-06-04 |
| 1356673271 | Joshua Nathanael Honeyman | Surgery | 2 Dudley St Ste 190, Providence, RI 02905 | 2010-02-02 |
| 1093974974 | Alexis Deana Smith | Surgery | 593 Eddy St, Providence, RI 02903-4923 | 2008-06-05 |
| 1720060726 | Christopher S Muratore | Surgery | 2 Dudley St, Suite 190, Providence, RI 02905-3236 | 2005-11-16 |
| 1124025937 | Francois I Luks | Surgery | 2 Dudley St, Suite 190, Providence, RI 02905-3236 | 2005-07-07 |
| City | PROVIDENCE |
| Zip Code | 02905 |
Please comment or provide details below to improve the information on DR. PETER KIM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.