Individual
DR. JONG K KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
952 SETON DR, CUMBERLAND, MD 21502-1950
(301) 777-3522
(301) 777-1902
Mailing address
PO BOX 808, CUMBERLAND, MD 21501-0808
(301) 724-1646
(301) 724-7429
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D46088
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015256100019
—
PA
05
—
0120562000
—
WV
01
—
37054
HIGHMARK BLUE SHIELD
PA
01
—
J2470001
GHMSI
MD
01
—
J2480001
GHMSI
MD
01
—
J2490001
GHMSI
MD
01
—
P00059981
MEDICARE RAILROAD
—
Enumeration date
05/25/2005
Last updated
03/13/2008
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