Individual
SAM KIM
Active
Individual
SAM KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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