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NPI Code Detail

MEDICARE: CHRISTOPHER JAEHOON SHIM JD, MD

MEDICARE: CHRISTOPHER JAEHOON SHIM JD, MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician1025863MA

General Provider Information

NPI Number : 1174215735
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER JAEHOON SHIM JD, MD
Provider Business Mailing Address
First Line : 506 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 718-780-3000
Fax Number :
Provider Business Practice Location Address
First Line : 506 6TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11215-3609
Country : US
Telephone Number : 718-780-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2023
Last Update Date : 05/27/2026

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