Individual
SAM KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 277-8668
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 277-8668
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
25MA08673600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001412293
HIGHMARK BLUE SHIELD
PA
01
—
2099400000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
06/22/2006
Last updated
03/05/2020
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