Individual
GRACE P KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4699 MAIN ST STE 201, BRIDGEPORT, CT 06606-1830
(203) 659-1599
(203) 382-0189
Mailing address
PO BOX 797, WILTON, CT 06897-0797
(203) 659-1599
(203) 382-0189
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
031353
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001313535
—
CT
Enumeration date
05/04/2006
Last updated
03/26/2019
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