Individual
DR. BONG-SOO KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3509 N BROAD ST, PHILADELPHIA, PA 19140-4105
(215) 707-7200
(215) 707-3831
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-7200
(215) 707-3831
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
MD 434999
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063553498
1063553498
PA
Enumeration date
03/31/2009
Last updated
05/01/2018
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