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Individual
TRACEY KIM
Active
Individual
TRACEY KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
223280
OR
2086S0102X
Surgical Critical Care Physician
223280
OR
2086S0127X
Trauma Surgery Physician
Primary
223280
OR
Other
Enumeration date
04/18/2015
Last updated
04/22/2025
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