Individual
IN TAE KIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
655 WATKINS MILL RD, GAITHERSBURG, MD 20879-3301
(240) 632-4000
Mailing address
11328 LIBERTY ST, FULTON, MD 20759-2509
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D85107
MD
Other
Enumeration date
05/19/2010
Last updated
06/27/2021
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