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General NPI Number Information
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NPI Number | 1982607933
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Entity Type | Organization
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Legal Business Name | ADR LLC
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 952 SETON DR
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City | CUMBERLAND
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State | MD
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Zip | 21502-1950
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Country | US
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Telephone | 301-777-3522
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Fax | 301-777-1902
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Provider Business Mailing Address
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Address Line | PO BOX 808
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City | CUMBERLAND
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State | MD
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Zip | 21501-0808
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Country | US
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Telephone | 301-724-1646
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Fax | 301-724-7429
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JONG K KIM
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Credential | MD
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Telephone | 301-724-1646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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