| Katherine K. Miura, Md, Llc | |
|
564 Loring Ave Unit 2 Salem MA 01970-4276 | |
| (978) 594-1662 | |
| (978) 336-5887 |
| Full Name | Katherine K. Miura, Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 564 Loring Ave, Salem, Massachusetts |
| Authorized Official Name and Position | Katherine Kimi Miura (OWNER) |
| Authorized Official Contact | 9785941662 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katherine K. Miura, Md, Llc 564 Loring Ave Unit 2 Salem MA 01970-4276 Ph: (978) 594-1662 | Katherine K. Miura, Md, Llc 564 Loring Ave Unit 2 Salem MA 01970-4276 Ph: (978) 594-1662 |
| NPI Number | 1457642894 |
|---|---|
| Provider Enumeration Date | 04/19/2011 |
| Last Update Date | 04/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457642894 | NPI | - | NPPES |
| 1801853007 | Other | MA | NPI TYPE 1 |
| 3156486 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 81163 (Massachusetts) | Primary |
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