Provider Demographics
NPI:1306074968
Name:KOH, EUN KYUNG
Entity type:Individual
Prefix:
First Name:EUN KYUNG
Middle Name:
Last Name:KOH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 HARRISON AVE #605
Mailing Address - Street 2:PMB 62564
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2308
Mailing Address - Country:US
Mailing Address - Phone:888-404-4813
Mailing Address - Fax:888-675-4061
Practice Address - Street 1:68 HARRISON AVE #605
Practice Address - Street 2:PMB 62564
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-2308
Practice Address - Country:US
Practice Address - Phone:888-404-4813
Practice Address - Fax:888-675-4061
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0027516207RE0101X
MO2024037013207RE0101X
OH35C.001905207RE0101X
AK224368207RE0101X
MEMD28759207RE0101X
VT042.0018132207RE0101X
IN01095909A207RE0101X
LA344073207RE0101X
AZ75162207RE0101X
MS34198207RE0101X
IAMD-53789207RE0101X
HIMD-24439-0207RE0101X
IL036.173869207RE0101X
WAMD60448667207RE0101X
FLME170392207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism