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NPI Code Detail

MEDICARE: DAHAE KIM

MEDICARE: DAHAE KIM
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
1183500000XPharmacist23675MD

General Provider Information

NPI Number : 1912451568
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAHAE KIM
Provider Business Mailing Address
First Line : 11729 BELTSVILLE DR
Second Line :
City : BELTSVILLE
State : MD
Zip : 20705-3147
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8501 FORT SMALLWOOD RD
Second Line :
City : PASADENA
State : MD
Zip : 21122-2607
Country : US
Telephone Number : 410-437-1149
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2016
Last Update Date : 08/11/2016

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Directions to “ DAHAE KIM ” Practice Location

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