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General NPI Number Information
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NPI Number | 1336452499
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Entity Type | Organization
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Legal Business Name | HOWARD COUNTY ENT, LLC
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Dates
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Enumeration Date | 07/19/2010
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Last Update Date | 03/22/2011
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Provider Practice Location Address
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Address Line | 6755 BUSINESS PKWY SUITE 302
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City | ELKRIDGE
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State | MD
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Zip | 21075-6340
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Country | US
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Telephone | 443-430-9747
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Fax | 443-927-7374
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Provider Business Mailing Address
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Address Line | 6755 BUSINESS PKWY SUITE 302
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City | ELKRIDGE
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State | MD
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Zip | 21075-6340
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Country | US
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Telephone | 443-430-9747
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Fax | 443-927-7374
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUNGJOO BRIAN KIM
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Credential | M.D.
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Telephone | 443-430-9747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD425368
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License Number State | MD
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