Provider Demographics
NPI:1194788604
Name:KUM, ROBERT NICHOLAS (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NICHOLAS
Last Name:KUM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-6700
Mailing Address - Country:US
Mailing Address - Phone:781-488-3388
Mailing Address - Fax:781-488-3363
Practice Address - Street 1:406 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-6700
Practice Address - Country:US
Practice Address - Phone:781-488-3388
Practice Address - Fax:781-488-3363
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA51574OtherHARVARD PILGRIM
MAY36881OtherBLUE CROSS/BLUE SHIELD
MA695189OtherACN
MAV05285Medicare UPIN
MAKU-Y45791Medicare ID - Type Unspecified