Individual
DR. SUSIE C KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MERCADO ST, STE 130, DURANGO, CO 81301-7306
(970) 247-1120
(970) 247-1128
Mailing address
1 MERCADO ST, STE 130, DURANGO, CO 81301-7306
(970) 247-1120
(970) 247-1128
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
41867
CO
207RI0011X
Interventional Cardiology Physician
41867
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026280600
—
NE
05
—
10026280700
—
NE
05
—
10026280800
—
NE
05
—
10026281000
—
NE
05
—
10026281200
—
NE
05
—
10026283100
—
NE
05
—
1982948089
—
NE
05
—
201038550A
—
KS
05
—
57723834
—
CO
Enumeration date
10/06/2005
Last updated
09/30/2022
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