Individual
KEVIN KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 S GREENE ST STE S-12D, BALTIMORE, MD 21201-1544
(410) 328-8621
Mailing address
655 W BALTIMORE ST, BALTIMORE, MD 21201-1509
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40014856100
—
MD
Enumeration date
04/15/2021
Last updated
03/29/2022
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