| Doctor K Llc | |
|
5074 Dorsey Hall Dr Ste 104 Ellicott City MD 21042-7794 | |
| (443) 766-3332 | |
| Not Available |
| Full Name | Doctor K Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5074 Dorsey Hall Dr Ste 104, Ellicott City, Maryland |
| Authorized Official Name and Position | Victor Y Kim (OWNER) |
| Authorized Official Contact | 4435708035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Doctor K Llc 5074 Dorsey Hall Dr Ste 104 Ellicott City MD 21042-7794 Ph: (443) 766-3332 | Doctor K Llc 5074 Dorsey Hall Dr Ste 104 Ellicott City MD 21042-7794 Ph: (443) 766-3332 |
| NPI Number | 1225536915 |
|---|---|
| Provider Enumeration Date | 01/27/2018 |
| Last Update Date | 02/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225536915 | NPI | - | NPPES |
| 416570500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | D51586 (Maryland) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
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