Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD458633 | PA |
N | 111NI0900X | Internist | MD458633 | PA |
N | 207RC0200X | Critical Care Medicine | MD458633 | PA |
Y | 207RP1001X | Pulmonary Disease | MD458633 | PA |
N | 207RP1001X | Pulmonary Disease | MT209041 | PA |
N | 208200000X | Surgeon | 4301097151 | MI |
N | 208600000X | Surgeon | 4301097151 | MI |
NPI | 1063726461 |
---|---|
Provider Name | Dr. David Eun Kim |
First Address | Hanover, PA 17331-1587 |
Second Address | Hanover, PA 17331-1587 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2010 |
Last Update Date | 10/12/2020 |