Individual
SANG TAEK KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
330 ORCHARD ST, NEW HAVEN, CT 06511-4417
(203) 680-7050
(203) 785-7053
Mailing address
330 ORCHARD ST, NEW HAVEN, CT 06511-4417
(203) 680-7050
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
047978
CT
207RR0500X
Rheumatology Physician
Q6526
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
354544401
—
TX
01
—
354544402
RHEUMATOLOGY
TX
Enumeration date
07/24/2009
Last updated
05/10/2023
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