Individual
ANDREW KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-7237
Mailing address
1500 MARKET ST, 24TH FLOOR-WEST TOWER, PHILADELPHIA, PA 19102-2100
(215) 255-3828
(215) 255-3577
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
MD067042L
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD067042
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00283090
RAILROAD MEDICARE
NJ
Enumeration date
06/28/2006
Last updated
06/17/2021
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