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NPI Code Detail

MEDICARE: ANNE EUNYOUNG KIM MD

MEDICARE: ANNE EUNYOUNG 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1891314738
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE EUNYOUNG KIM MD
Provider Business Mailing Address
First Line : 2492 DERBYSHIRE RD APT 1
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-3289
Country : US
Telephone Number : 330-606-3160
Fax Number :
Provider Business Practice Location Address
First Line : 3400 SPRUCE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4238
Country : US
Telephone Number : 215-662-2730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2020
Last Update Date : 04/13/2020

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