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Individual

BYUNG J KIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1 HOSPITAL DR, FARMINGTON, ME 04938-9641
(207) 778-6031
(207) 779-2433
Mailing address
PO BOX 1849, LEWISTON, ME 04241-1849
(207) 784-2554
(207) 777-5363

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
016688
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010538626
CHAMPUS
01
022291
BLUE CROSS/BLUE SHIELD
ME
05
312270099
ME
01
P00073383
RR MEDICARE
Enumeration date
09/13/2005
Last updated
11/26/2012
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