Individual
SOON JA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5808 MAIN ST, ELKRIDGE, MD 21075-5105
(410) 796-7730
(410) 379-1537
Mailing address
5808 MAIN ST, ELKRIDGE, MD 21075-5105
(410) 796-7730
(410) 379-1537
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0022832
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
794391100
—
MD
Enumeration date
12/23/2005
Last updated
09/22/2021
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