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General NPI Number Information
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NPI Number | 1629811526
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Entity Type | Individual
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Provider Name | TIFFANY EVA KIM DO
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Gender | Female
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Dates
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Enumeration Date | 06/17/2024
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 320 E NORTH AVE
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City | PITTSBURGH
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State | PA
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Zip | 15212-4756
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Country | US
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Telephone | 412-359-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 169 ASHLEY AVE, ROOM 202 MAIN HOSPITAL MSC333
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City | CHARLESTON
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State | SC
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Zip | 29425-8905
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Country | US
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Telephone |
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | LL91452
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | OT024709
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License Number State | PA
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