Individual
DOO TAE KIM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 S 21ST ST, EASTON, PA 18042-3851
(610) 250-4303
Mailing address
PO BOX 18764, NEWARK, NJ 07191-8764
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD-034047-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0647583
—
PA
Enumeration date
06/09/2005
Last updated
07/08/2007
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