| Doctor Name: | DR. DAVID JUNG SUG SHIM |
| NPI Number: | 1124335856 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 7738 |
| Business Practice Address: | 1507 Washington St West Newton, MA - 024652219 |
| Business Phone Number: | 7819855745 |
| Business Fax Number: | |
| Mailing Address: | 11 Beaver St, WALTHAM |
| State: | MA |
| Postal Code: | 024537003 |
| Phone Number: | 7818930611 |
| Fax Number: | |
| NPI Enumeration Date: | 09/01/2010 |
| NPI Last Update Date: | 09/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 7738 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |