Individual
DR. SAM Y KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1919 LATHROP ST, STE 103, FAIRBANKS, AK 99701-5937
(907) 456-7768
(907) 456-4045
Mailing address
1919 LATHROP ST, STE 103, FAIRBANKS, AK 99701-5937
(907) 456-7768
(907) 456-4045
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
01051686A
IN
207Y00000X
Otolaryngology Physician
Primary
5779
AK
207Y00000X
Otolaryngology Physician
A99387
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD0304
—
AK
Enumeration date
12/19/2006
Last updated
04/01/2016
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