Individual
DR. MARK M KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7927 RITCHIE HWY., GLEN BURNIE, MD 21061
(410) 761-2273
Mailing address
301 ST. PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0054574
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2197875
AETNA
MD
05
—
730901500
—
MD
01
—
KF68 / 607687-01, 02
BC/BS OF MD
MD
01
—
S190 / 0009
BLUE CHOICE
MD
Enumeration date
07/10/2006
Last updated
06/25/2018
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