Provider Demographics
NPI:1548551229
Name:HSIA-KIUNG, MAXIMILIAN EVAN (MD)
Entity type:Individual
Prefix:
First Name:MAXIMILIAN
Middle Name:EVAN
Last Name:HSIA-KIUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MAXIMILIAN
Other - Middle Name:EVAN
Other - Last Name:HSIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:GRB 444
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-3030
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:GRB 444
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266835207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology