Organization
SOON JA KIM MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOON JA KIM MD (PRESIDENT)
(410) 796-7730
Entity
Organization
Contact information
Practice address
5808 MAIN ST, ELKRIDGE, MD 21075-5105
(410) 796-7730
(410) 379-1537
Mailing address
5808 MAIN ST, ELKRIDGE, MD 21075-5105
(410) 796-7730
(410) 379-1537
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010003063
MEDICARE RAILROAD
MD
05
—
794391100
—
MD
Enumeration date
03/18/2010
Last updated
04/21/2010
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