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General NPI Number Information
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NPI Number | 1003893116
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Entity Type | Individual
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Provider Name | YOON JUNG KIM MD
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Gender | Female
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 12/31/2009
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Provider Practice Location Address
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Address Line | 9114 PHILADELPHIA RD SUITE 108 STE 108, MEDICAL HEALTH GROUP AT WHITE MARSH
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City | BALTIMORE
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State | MD
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Zip | 21237-4317
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Country | US
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Telephone | 410-918-0777
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Fax | 410-369-1707
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Provider Business Mailing Address
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Address Line | 9114 PHILADELPHIA RD SUITE 108 STE 108, MEDICAL HEALTH GROUP AT WHITE MARSH
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City | BALTIMORE
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State | MD
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Zip | 21237-4317
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Country | US
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Telephone | 410-918-0777
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Fax | 410-369-1707
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | D0047157
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License Number State | MD
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