Healthcare Provider Details

I. General information

NPI: 1922006931
Provider Name (Legal Business Name): CHRISTOPHER Y. KIM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S CATON AVE
BALTIMORE MD
21229-5299
US

IV. Provider business mailing address

900 S CATON AVE MAILBOX 037
BALTIMORE MD
21229-5299
US

V. Phone/Fax

Practice location:
  • Phone: 667-234-2200
  • Fax: 667-234-3515
Mailing address:
  • Phone: 667-234-2200
  • Fax: 667-234-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0056588
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: