Individual
JOHN J KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 LANSDOWNE AVE, #209, DARBY, PA 19023-1333
(610) 534-6370
(610) 534-6374
Mailing address
1501 LANSDOWNE AVE, #209, DARBY, PA 19023-1333
(610) 534-6370
(610) 534-6374
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD035999Y
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006886200002
—
PA
01
—
0053346000
KEYSTONE HEALTH PLAN EAST
—
01
—
6138
AETNA
—
Enumeration date
07/19/2006
Last updated
07/08/2007
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