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General NPI Number Information
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NPI Number | 1114986817
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Entity Type | Individual
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Provider Name | DANIEL LEE KIM MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 07/08/2022
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Provider Practice Location Address
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Address Line | 132 ABIGAIL LN
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City | PORT MATILDA
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State | PA
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Zip | 16870-7153
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Country | US
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Telephone | 814-272-5011
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Fax | 814-272-6531
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE
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City | DANVILLE
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State | PA
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Zip | 17822-4903
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Country | US
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Telephone | 570-271-6144
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Fax | 570-271-6578
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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 | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | D00065837
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 223931
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | MD065991L
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License Number State | PA
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