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Individual

MARK INBO SHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
237 82ND STREET, BROOKLYN, NY 11209
(718) 836-0009
(718) 836-1811
Mailing address
237 82ND STREET, BROOKLYN, NY 11209
(718) 836-0009
(718) 836-1811

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
179695
NY
207RC0000X
Cardiovascular Disease Physician
25MA05388000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01273990
NY
Enumeration date
08/09/2006
Last updated
10/23/2011
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