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Individual

PHILLIP KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6000
Mailing address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD479690
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/05/2017
Last updated
07/25/2023
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