EUN KYUNG KOH
Complete NPI Record 1306074968
Internal Medicine - Endocrinology, Diabetes & Metabolism in Boston, MA

Active since June 22, 2009PECOS Enrolled

56 BROAD ST STE 14281, BOSTON, MA 02109(888) 404-4813(888) 675-4061 Get Directions

NPPES record last updated: October 31, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 11, 2025, Jun 3, 2025, Mar 25, 2025 and 6 more (9 updates tracked since 2016).

Complete NPI Dataset

This page contains the complete raw NPPES record for Eun Kyung Koh (NPI 1306074968), an individual internal medicine provider in Boston, MA. All 83 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.

Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.

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NPI: 1306074968: The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1: Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal Name: KOH: The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: EUN KYUNG: The first name of the provider, if the provider is an individual.
Provider First Line Business Mailing Address: 56 BROAD ST STE 14281: The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City Name: BOSTON: The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MA: The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code: 021094301: The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Country Code If outside U S : US: The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
Provider Business Mailing Address Telephone Number: 8884044813: The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number: 8886754061: The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Provider First Line Business Practice Location Address: 56 BROAD ST STE 14281: The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: BOSTON: The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: MA: The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 021094301: The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US: The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 8884044813: The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8886754061: The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/22/2009: The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 10/31/2025: The date that a record was last updated or changed.
Provider Gender Code: F: The code designating the provider's gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: MD-53789: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 1: IA: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 1: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 2: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 2: 2024037013: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 2: MO: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 2: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 3: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 3: 75162: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 3: AZ: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 3: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 4: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 4: ME170392: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 4: FL: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 4: Y: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 5: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 5: MD60448667: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 5: WA: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 5: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 6: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 6: C1-0027516: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 6: DE: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 6: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 7: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 7: 35C.001905: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 7: OH: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 7: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 8: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 8: MD28759: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 8: ME: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 8: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 9: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 9: 34198: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 9: MS: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 9: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 10: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 10: 224368: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 10: AK: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 10: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 11: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 11: 344073: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 11: LA: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 11: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 12: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 12: 042.0018132: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 12: VT: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 12: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 13: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 13: MD-24439-0: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 13: HI: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 13: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 14: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 14: 01095909A: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 14: IN: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 14: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Healthcare Provider Taxonomy Code 15: 207RE0101X: This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 15: 036.173869: The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
Provider License Number State Code 15: IL: The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
Healthcare Provider Primary Taxonomy Switch 15: N: This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
Is Sole Proprietor: N: Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
NPI Certification Date: 10/31/2025: The date on which the National Provider Identifier (NPI) was officially assigned and certified to the provider. This reflects when the provider's NPI record first became active in the NPPES system.

Secondary Practice Locations 35

The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.

2 Office Park Ct Ste 103

1/35

Columbia, SC 29223-5948 · Phone (888) 404-4813 · Fax (888) 675-4061

319 Coteau St

2/35

Pierre, SD 57501-3187 · Phone (888) 404-4813 · Fax (888) 675-4061

1108 E South Union Ave

3/35

Midvale, UT 84047-2904 · Phone (888) 404-4813 · Fax (888) 675-4061

4701 Cox Rd Ste 285

4/35

Glen Allen, VA 23060-6808 · Phone (888) 404-4813 · Fax (888) 675-4061

1010 Dale St N

5/35

Saint Paul, MN 55117-5603 · Phone (888) 404-4813 · Fax (888) 675-4061

300 Montvue Rd

6/35

Knoxville, TN 37919-5510 · Phone (888) 404-4813 · Fax (888) 675-4061

208 S LaSalle St., Suite 814

7/35

Chicago, IL 60604-1101 · Phone (888) 404-4813 · Fax (888) 675-4061

1833 S Morgan Rd

8/35

Oklahoma City, OK 73128-7004 · Phone (888) 404-4813 · Fax (888) 675-4061

600 N 2nd St Ste 401

9/35

Harrisburg, PA 17101-1071 · Phone (888) 404-4813 · Fax (888) 675-4061

320 S Izard St

10/35

Little Rock, AR 72201-2114 · Phone (888) 404-4813 · Fax (888) 675-4061

2405 York Rd Ste 201

11/35

Lutherville Timonium, MD 21093-2252 · Phone (888) 404-4813 · Fax (888) 675-4061

357 E Center St Ste 2J

12/35

Manchester, CT 06040-4471 · Phone (888) 404-4813 · Fax (888) 675-4061

301 S Bedford St Ste 1

13/35

Madison, WI 53703-3691 · Phone (888) 404-4813 · Fax (888) 675-4061

306 W Main St Ste 512

14/35

Frankfort, KY 40601-1840 · Phone (888) 404-4813 · Fax (888) 675-4061

334 N Senate Ave

15/35

Indianapolis, IN 46204-1708 · Phone (888) 404-4813 · Fax (888) 675-4061

450 Veterans Memorial Pkwy Ste 7A

16/35

East Providence, RI 02914-5315 · Phone (888) 404-4813 · Fax (888) 675-4061

645 Lakeland East Dr Ste 101

17/35

Flowood, MS 39232-9099 · Phone (888) 404-4813 · Fax (888) 675-4061

400 E Court Ave

18/35

Des Moines, IA 50309-2027 · Phone (888) 404-4813 · Fax (888) 675-4061

3 Chase Ave

19/35

Augusta, ME 04330-4525 · Phone (888) 404-4813 · Fax (888) 675-4061

95B Main Street

20/35

Jeffersonville, VT 05464 · Phone (888) 404-4813 · Fax (888) 675-4061

4400 Easton Cmns Ste 125

21/35

Columbus, OH 43219-6223 · Phone (888) 404-4813 · Fax (888) 675-4061

120 S Central Ave

22/35

Clayton, MO 63105-1705 · Phone (888) 404-4813 · Fax (888) 675-4061

711 Capitol Way S Ste 204

23/35

Olympia, WA 98501-1267 · Phone (888) 404-4813 · Fax (888) 675-4061

3800 N Central Ave

24/35

Phoenix, AZ 85012-1992 · Phone (888) 404-4813 · Fax (888) 675-4061

7700 E Arapahoe Rd Ste 220

25/35

Centennial, CO 80112-1268 · Phone (888) 404-4813 · Fax (888) 675-4061

155 Federal St Ste 700

26/35

Boston, MA 02110-1727 · Phone (888) 404-4813 · Fax (888) 675-4061

40600 Ann Arbor Rd E Ste 201

27/35

Plymouth, MI 48170-4675 · Phone (888) 404-4813 · Fax (888) 675-4061

3867 Plaza Tower Dr

28/35

Baton Rouge, LA 70816-4378 · Phone (888) 404-4813 · Fax (888) 675-4061

1200 S Pine Island Rd

29/35

Plantation, FL 33324-4413 · Phone (888) 404-4813 · Fax (888) 675-4061

900 Fort Street Mall Ste 1680

30/35

Honolulu, HI 96813-3716 · Phone (888) 404-4813 · Fax (888) 675-4061

8585 Old Dairy Rd Ste 208

31/35

Juneau, AK 99801-8094 · Phone (888) 404-4813 · Fax (888) 675-4061

1209 N Orange St

32/35

Wilmington, DE 19801-1120 · Phone (888) 404-4813 · Fax (888) 675-4061

1015 15th St NW Ste 1000

33/35

Washington, DC 20005-2621 · Phone (888) 404-4813 · Fax (888) 675-4061

2 1/2 Beacon St

34/35

Concord, NH 03301-4447 · Phone (888) 404-4813 · Fax (888) 675-4061

206 S Coronado Ave

35/35

Espanola, NM 87532-2792 · Phone (888) 404-4813 · Fax (888) 675-4061

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