MEDICARE: PATRICK K KIM 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
1	2086S0102X	Surgical Critical Care Physician	MD066657L	PA
2	2086S0127X	Trauma Surgery Physician	MD066657L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205866860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK K KIM MD

Provider Business Mailing Address
First Line	:	51 NORTH 39TH STREET
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2640
Country	:	US
Telephone Number	:	215-349-8310
Fax Number	:	215-724-3560

Provider Business Practice Location Address
First Line	:	51 NORTH 39TH STREET
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-2640
Country	:	US
Telephone Number	:	215-349-8310
Fax Number	:	215-724-3560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	05/26/2026

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