Soon Ja Kim, MD
Family Medicine in Elkridge, MD. Individual provider (NPI-1).
NPI number1023095643
StatusActive
Last updated in NPPESSep 22, 2021
Details
- NPI
- 1023095643
- Entity type
- Individual (NPI-1)
- Name
- Soon Ja Kim
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 23, 2005
- Certification date
- Sep 22, 2021
- Last updated
- Sep 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | D0022832 | MD | Yes |
Practice location
5808 Main StElkridge, MD 21075-5105
Phone 410-796-7730 · Fax 410-379-1537
Mailing address
5808 Main StElkridge, MD 21075-5105
Phone 410-796-7730 · Fax 410-379-1537
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