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NPI Code Detail

MEDICARE: REBECCA KIM

MEDICARE:   REBECCA  KIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturistU02576MD

General Provider Information

NPI Number : 1740750777
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA KIM
Provider Business Mailing Address
First Line : 1412 CRAIN HWY N STE 7A
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-7000
Country : US
Telephone Number : 410-761-2988
Fax Number :
Provider Business Practice Location Address
First Line : 1412 CRAIN HWY N STE 7A
Second Line :
City : GLEN BURNIE
State : MD
Zip : 21061-7000
Country : US
Telephone Number : 410-761-2988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2018
Last Update Date : 12/03/2018

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Directions to “ REBECCA KIM ” Practice Location

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