Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | C10006691 | DE |
NPI | 1003877580 |
---|---|
Provider Name | Nancy Kim |
First Address | Newark, DE 19713 |
Second Address | Newark, DE 19713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2006 |
Last Update Date | 16/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2230869000 | AMERIHEALTH (01) | DE |
3295888 | AETNA (01) | DE |
510110596 | BCBS DE (01) | DE |
510110596 | COVENTRY (01) | DE |
H93131 | (02) |