| Sue E Kim M.d., Llc | |
|
1205 York Rd Ste 35 Lutherville MD 21093-6211 | |
| (410) 321-5502 | |
| (410) 785-1988 |
| Full Name | Sue E Kim M.d., Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1205 York Rd Ste 35, Lutherville, Maryland |
| Authorized Official Name and Position | Sue E Kim (ONE PERSON LLC) |
| Authorized Official Contact | 4103215502 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sue E Kim M.d., Llc 1205 York Rd Ste 35 Lutherville MD 21093-6211 Ph: (410) 321-5502 | Sue E Kim M.d., Llc 1205 York Rd Ste 35 Lutherville MD 21093-6211 Ph: (410) 321-5502 |
| NPI Number | 1588845812 |
|---|---|
| Provider Enumeration Date | 11/15/2007 |
| Last Update Date | 12/10/2007 |
| Medicare PECOS PAC ID | 6305039678 |
|---|---|
| Medicare Enrollment ID | O20101019000769 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588845812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | D0041868 (Maryland) | Primary |
| Provider Name | Sue E Kim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407953060 PECOS PAC ID: 3779776042 Enrollment ID: I20101019000748 |
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