Healthcare Provider Details

I. General information

NPI: 1003565235
Provider Name (Legal Business Name): DOROTHY YIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1830 E MONUMENT ST STE 6-100
BALTIMORE MD
21287-0020
US

IV. Provider business mailing address

27720 STEPHENSON HWY APT 112
MADISON HEIGHTS MI
48071-3154
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5107
  • Fax:
Mailing address:
  • Phone: 626-715-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0107543
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: