Individual
MARK SEJUN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
Mailing address
111 S 11TH ST, SUITE 8490, PHILADELPHIA, PA 19107-4824
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD448180
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0365378
—
NJ
05
—
102848574
—
PA
Enumeration date
04/01/2009
Last updated
11/13/2013
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