Provider Demographics
NPI:1811987225
Name:HJALMARSON, KARIN INGRID (MD)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:INGRID
Last Name:HJALMARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:822 BOYLSTON ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-2595
Mailing Address - Country:US
Mailing Address - Phone:617-396-8866
Mailing Address - Fax:617-505-6102
Practice Address - Street 1:822 BOYLSTON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-2595
Practice Address - Country:US
Practice Address - Phone:617-396-8866
Practice Address - Fax:617-505-6102
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA224129207R00000X
FLME109711207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2104857Medicaid