Individual
ELLEN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7500 JEFFERSON ST NE STE 210, ALBUQUERQUE, NM 87109-4384
(505) 821-5404
Mailing address
908 GRECIAN AVE NW, ALBUQUERQUE, NM 87107-5733
(505) 506-1984
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
97-289
NM
Other
Enumeration date
11/29/2006
Last updated
01/19/2023
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